Idaho
Division of Occupational and Professional Licenses
ANN MARIE BLACK
Board Of Medicine
License number
D-447
Date granted
08/25/2004
Date expires
08/01/2014
Class
Board Of Medicine
Status
Canceled
Address
2435 S 2010 E SAINT GEORGE UT 84790
idaholicensing.com
ID 48329234
LAST UPDATED 2024-02-18 03:01:23 UTC
LAST UPDATED 2024-02-18 03:01:23 UTC
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