License holder summary

I SAM MIYATAKE is a Board Of Medicine licensed to practice in Idaho. The address on file for I SAM MIYATAKE is 182 Green Oaks Dr OZARK MO 65721. This licensed professional license is not current. The license was granted 07/07/1974.

Idaho

Division of Occupational and Professional Licenses

I SAM MIYATAKE
Board Of Medicine
License number
M-3257
Date granted
07/07/1974
Class
Board Of Medicine
Status
Deceased
Address
182 Green Oaks Dr OZARK MO 65721
idaholicensing.com
ID 48335343
LAST UPDATED 2024-04-25 12:29:52 UTC

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