Idaho
Division of Occupational and Professional Licenses
ERIC W. POLK
Board Of Medicine
License number
M-4158
Date granted
05/12/1980
Date expires
07/01/1975
Class
Board Of Medicine
Status
Canceled
Address
9400 Ridge Road ZEPHYRHILLS FL 33542
idaholicensing.com
ID 48357094
LAST UPDATED 2024-03-16 15:19:33 UTC
LAST UPDATED 2024-03-16 15:19:33 UTC
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