Idaho
Division of Occupational and Professional Licenses
DEREK RON WYNN
Board Of Medicine
License number
PA-1276
Date granted
08/28/2015
Date expires
06/30/2017
Class
Board Of Medicine
Status
Licensed
Address
104 S Boulevard St Grangeville ID 83530
idaholicensing.com
ID 48389373
LAST UPDATED 2024-03-16 16:29:26 UTC
LAST UPDATED 2024-03-16 16:29:26 UTC
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