Idaho
Division of Occupational and Professional Licenses
DOUGLAS UGENE BLANK
Board Of Medicine
License number
M-7866
Date granted
09/11/1999
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
2985 Cortez Ave IDAHO FALLS ID 83404
idaholicensing.com
ID 48336919
LAST UPDATED 2024-02-25 14:28:19 UTC
LAST UPDATED 2024-02-25 14:28:19 UTC
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