Idaho
Division of Occupational and Professional Licenses
CARLOS BAUTISTA
Board Of Medicine
License number
MRM-1220
Date granted
07/01/2011
Date expires
06/30/2013
Class
Board Of Medicine
Status
Expired
Address
777 N RAYMOND ST BOISE ID 83704
idaholicensing.com
ID 48338489
LAST UPDATED 2024-04-05 00:59:23 UTC
LAST UPDATED 2024-04-05 00:59:23 UTC
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