Idaho
Division of Occupational and Professional Licenses
KATHLEEN ANNE HANNIFAN
Board Of Medicine
License number
MRM-0962
Date granted
07/23/2007
Date expires
09/20/2007
Class
Board Of Medicine
Status
Expired
Address
PO BOX 4730 POCATELLO ID 83205
idaholicensing.com
ID 48349638
LAST UPDATED 2026-04-06 19:05:45 UTC
LAST UPDATED 2026-04-06 19:05:45 UTC
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