License holder summary

JACE ANTHONY BIRD is a Board Of Medicine licensed to practice in Idaho. The address on file for JACE ANTHONY BIRD is 383 W 170 N APT 4 BLACKFOOT ID 83221. This licensed professional license is not current. The license was granted 08/15/2007 and expired on 07/31/2010.

Idaho

Division of Occupational and Professional Licenses

JACE ANTHONY BIRD
Board Of Medicine
License number
O-0453
Date granted
08/15/2007
Date expires
07/31/2010
Class
Board Of Medicine
Status
Canceled
Address
383 W 170 N APT 4 BLACKFOOT ID 83221
idaholicensing.com
ID 48340792
LAST UPDATED 2024-03-17 22:04:42 UTC

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