Idaho
Division of Occupational and Professional Licenses
MARK L PETERSEN
Board Of Medicine
License number
M-4885
Date granted
04/03/1985
Date expires
08/01/2016
Class
Board Of Medicine
Status
Canceled
Address
2940 Balboa Dr Idaho Falls ID 83404
idaholicensing.com
ID 48348785
LAST UPDATED 2024-03-27 07:28:25 UTC
LAST UPDATED 2024-03-27 07:28:25 UTC
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