Idaho
Division of Occupational and Professional Licenses
Dr. THOMAS HEACOCK
Board Of Medicine
License number
M-12582
Date granted
08/01/2014
Date expires
08/01/2016
Class
Board Of Medicine
Status
Canceled
Address
340 KOLMAR ST LA JOLLA CA 92037
idaholicensing.com
ID 48329339
LAST UPDATED 2026-03-17 18:51:57 UTC
LAST UPDATED 2026-03-17 18:51:57 UTC
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