Idaho
Division of Occupational and Professional Licenses
KIMBERLY JEAN WAGNER
Board Of Medicine
License number
D-618
Date granted
02/19/2010
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1351 JANE ST POCATELLO ID 83201
idaholicensing.com
ID 48334530
LAST UPDATED 2024-03-31 05:39:06 UTC
LAST UPDATED 2024-03-31 05:39:06 UTC
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