License holder summary

BRUCE WAYNE PETERSON is a Board Of Medicine licensed to practice in Idaho. The address on file for BRUCE WAYNE PETERSON is 384 W 300 N BLACKFOOT ID 83221. This licensed professional license is not current. The license was granted 10/30/2014 and expired on 09/01/2016.

Idaho

Division of Occupational and Professional Licenses

BRUCE WAYNE PETERSON
Board Of Medicine
License number
RTS-698
Date granted
10/30/2014
Date expires
09/01/2016
Class
Board Of Medicine
Status
Expired
Address
384 W 300 N BLACKFOOT ID 83221
idaholicensing.com
ID 48348814
LAST UPDATED 2024-03-31 23:59:39 UTC

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