Idaho
Division of Occupational and Professional Licenses
GLENN DAVID BLAISDELL
Board Of Medicine
License number
M-3166
Date granted
07/15/1973
Date expires
07/15/1973
Class
Board Of Medicine
Status
Canceled
Address
850 Boulder Drive Green River WY 82935
idaholicensing.com
ID 48334844
LAST UPDATED 2024-03-17 04:13:50 UTC
LAST UPDATED 2024-03-17 04:13:50 UTC
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