Idaho
Division of Occupational and Professional Licenses
CARL JAY PERGAM
Board Of Medicine
License number
M-8553
Date granted
06/21/2002
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
6507 258TH AVE NE REDMOND WA 98053
idaholicensing.com
ID 48350763
LAST UPDATED 2024-03-26 18:28:20 UTC
LAST UPDATED 2024-03-26 18:28:20 UTC
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