Idaho
Division of Occupational and Professional Licenses
MARK T. HATTENHAUER
Board Of Medicine
License number
M-4733
Date granted
03/10/1984
Class
Board Of Medicine
Status
Canceled
Address
10701 S.W. 25th Street Portland OR 97219
idaholicensing.com
ID 48338209
LAST UPDATED 2024-02-16 12:57:28 UTC
LAST UPDATED 2024-02-16 12:57:28 UTC
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