Idaho
Division of Occupational and Professional Licenses
DALE LEROY JACKSON
Board Of Medicine
License number
LRT-473
Date granted
12/20/1994
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
107 E Tucker Ave PARMA ID 83660
idaholicensing.com
ID 48329358
LAST UPDATED 2024-03-31 20:58:01 UTC
LAST UPDATED 2024-03-31 20:58:01 UTC
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