License holder summary

GRANT M PETERSON is a Board Of Medicine licensed to practice in Idaho. The address on file for GRANT M PETERSON is 1441 Parkway Dr BLACKFOOT ID 83221. This licensed professional license is not current. The license was granted 01/16/1977.

Idaho

Division of Occupational and Professional Licenses

GRANT M PETERSON
Board Of Medicine
License number
M-3589
Date granted
01/16/1977
Class
Board Of Medicine
Status
Canceled
Address
1441 Parkway Dr BLACKFOOT ID 83221
idaholicensing.com
ID 48348832
LAST UPDATED 2024-04-06 12:07:23 UTC

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