License holder summary

MARK EDWARD KIECKBUSCH is a Board Of Medicine licensed to practice in Idaho. The address on file for MARK EDWARD KIECKBUSCH is PO Box 881 BOISE ID 83701. This licensed professional license is current. The license was granted 09/12/1992 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

MARK EDWARD KIECKBUSCH
Board Of Medicine
License number
M-6070
Date granted
09/12/1992
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
PO Box 881 BOISE ID 83701
idaholicensing.com
ID 48342168
LAST UPDATED 2024-01-31 02:09:52 UTC

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