Idaho
Division of Occupational and Professional Licenses
Dr. MICHAEL JOHNATHAN MODICA
Board Of Medicine
License number
M-12051
Date granted
06/10/2013
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
877 WEST MAIN STREET BOISE ID 83702
idaholicensing.com
ID 48345281
LAST UPDATED 2024-03-30 00:15:32 UTC
LAST UPDATED 2024-03-30 00:15:32 UTC
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