Idaho
Division of Occupational and Professional Licenses
DEIDRA RAQUEL NICHOLS
Physical Therapy Licensure Board - Physical Therapist
License number
PT - 3043
Date granted
06/05/2012
Date expires
08/11/2017
Class
Physical Therapy Licensure Board - Physical Therapist
Status
Current
Address
BLACKFOOT ID 83221
idaholicensing.com
ID 43732482
LAST UPDATED 2024-03-05 02:04:24 UTC
LAST UPDATED 2024-03-05 02:04:24 UTC
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