Idaho
Division of Occupational and Professional Licenses
LEE SELF
Board Of Medicine
License number
M-7844
Date granted
09/11/1999
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
PO Box 759 Eagle ID 83616
idaholicensing.com
ID 48357060
LAST UPDATED 2024-01-30 23:29:21 UTC
LAST UPDATED 2024-01-30 23:29:21 UTC
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