Idaho
Division of Occupational and Professional Licenses
MARSHEL BRYON PRUIETT
Board Of Medicine
License number
LRT-1083
Date granted
11/12/2004
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
77 Rocky Mountain Ranch Rd Spirit Lake ID 83869
idaholicensing.com
ID 48362482
LAST UPDATED 2024-02-19 03:04:18 UTC
LAST UPDATED 2024-02-19 03:04:18 UTC
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