Idaho
Division of Occupational and Professional Licenses
GEOFFREY GUSTAVSEN
Board Of Medicine
License number
MRM-383
Date granted
05/03/1993
Class
Board Of Medicine
Status
Canceled
Address
6613 Ustick Rd. Boise ID 83704
idaholicensing.com
ID 48339181
LAST UPDATED 2024-03-25 20:11:46 UTC
LAST UPDATED 2024-03-25 20:11:46 UTC
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