License holder summary

CHARLES KENNETH REQUARD is a Board Of Medicine licensed to practice in Idaho. The address on file for CHARLES KENNETH REQUARD is 4251 BEAR CLAW WAY TUCSON AZ 85749. This licensed professional license is not current. The license was granted 03/03/2006 and expired on 06/30/2007.

Idaho

Division of Occupational and Professional Licenses

CHARLES KENNETH REQUARD
Board Of Medicine
License number
M-9524
Date granted
03/03/2006
Date expires
06/30/2007
Class
Board Of Medicine
Status
Canceled
Address
4251 BEAR CLAW WAY TUCSON AZ 85749
idaholicensing.com
ID 48348434
LAST UPDATED 2024-04-24 08:31:19 UTC

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