Idaho
Division of Occupational and Professional Licenses
CARLA MARY MANNON
Board Of Medicine
License number
LRT-1943
Date granted
05/12/2016
Date expires
06/30/2017
Class
Board Of Medicine
Status
Licensed
Address
201 S ASBURY ST APT 1 MOSCOW ID 83843
idaholicensing.com
ID 48360427
LAST UPDATED 2024-02-06 06:08:19 UTC
LAST UPDATED 2024-02-06 06:08:19 UTC
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