License holder summary

KANCHAN PURI CLARK is a Board Of Medicine licensed to practice in Idaho. The address on file for KANCHAN PURI CLARK is 23314 E Boone Ave Liberty Lake WA 99019. This licensed professional license is not current. The license was granted 09/10/1994 and expired on 07/02/1998.

Idaho

Division of Occupational and Professional Licenses

KANCHAN PURI CLARK
Board Of Medicine
License number
M-6583
Date granted
09/10/1994
Date expires
07/02/1998
Class
Board Of Medicine
Status
Canceled
Address
23314 E Boone Ave Liberty Lake WA 99019
idaholicensing.com
ID 48343668
LAST UPDATED 2024-02-27 20:24:21 UTC

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