Idaho
Division of Occupational and Professional Licenses
DIANA LA RAE CONNIE PLANE
Board Of Medicine
License number
PSG-005
Date granted
12/23/2003
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
514 East Third St Emmett ID 83617
idaholicensing.com
ID 48362342
LAST UPDATED 2024-04-13 18:08:30 UTC
LAST UPDATED 2024-04-13 18:08:30 UTC
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