Idaho
Division of Occupational and Professional Licenses
Dr. AMY NICOLE MANDEVILLE
Board Of Medicine
License number
M-12717
Date granted
11/05/2014
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
777 N. RAYMOND STREET BOISE ID 83704
idaholicensing.com
ID 48348996
LAST UPDATED 2024-02-13 17:33:09 UTC
LAST UPDATED 2024-02-13 17:33:09 UTC
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