Idaho
Division of Occupational and Professional Licenses
JACQUELYN NICOL CARLSSON
Board Of Medicine
License number
MSM-0449
Date granted
06/26/2014
Date expires
06/30/2015
Class
Board Of Medicine
Status
Expired
Address
13211 N STEVENS ST SPOKANE WA 99208
idaholicensing.com
ID 48342378
LAST UPDATED 2024-05-15 11:05:08 UTC
LAST UPDATED 2024-05-15 11:05:08 UTC
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