Idaho
Division of Occupational and Professional Licenses
BLAKE DAVID LOLLIS
Board Of Medicine
License number
M-6345
Date granted
09/20/1993
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
302 S 10TH AVE YAKIMA WA 98902
idaholicensing.com
ID 48357313
LAST UPDATED 2024-04-13 17:51:51 UTC
LAST UPDATED 2024-04-13 17:51:51 UTC
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