Idaho
Division of Occupational and Professional Licenses
IVY ANN HANSEN
Board Of Medicine
License number
PA-814
Date granted
09/08/2009
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
2065 E 17TH STREET "D" IDAHO FALLS ID 83404
idaholicensing.com
ID 48360679
LAST UPDATED 2024-04-28 13:29:07 UTC
LAST UPDATED 2024-04-28 13:29:07 UTC
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