Idaho
Division of Occupational and Professional Licenses
Dr. JARED Paul WAGNER
Board Of Medicine
License number
M-11989
Date granted
04/25/2013
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
98 Popular Street Blackfoot ID 83221
idaholicensing.com
ID 48334528
LAST UPDATED 2024-03-01 11:53:33 UTC
LAST UPDATED 2024-03-01 11:53:33 UTC
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