Idaho
Division of Occupational and Professional Licenses
CHANEL RAE CLARK
Board Of Medicine
License number
D-859
Date granted
04/07/2015
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
PO BOX 346 WEIPPE ID 83553
idaholicensing.com
ID 48343652
LAST UPDATED 2024-03-01 19:03:38 UTC
LAST UPDATED 2024-03-01 19:03:38 UTC
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