Idaho
Division of Occupational and Professional Licenses
C SHAWN CLUM
Board Of Medicine
License number
LRT-747
Date granted
11/19/1998
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
51 Hemlock St. MOYIE SPRINGS ID 83845
idaholicensing.com
ID 48343787
LAST UPDATED 2026-05-18 04:44:32 UTC
LAST UPDATED 2026-05-18 04:44:32 UTC
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