Idaho
Division of Occupational and Professional Licenses
KENNETH CHARLES STUPKA II
Board Of Medicine
License number
MRM-1469
Date granted
05/11/2015
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
777 N RAYMOND ST BOISE ID 83704
idaholicensing.com
ID 48355985
LAST UPDATED 2024-03-18 17:19:45 UTC
LAST UPDATED 2024-03-18 17:19:45 UTC
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