Idaho
Division of Occupational and Professional Licenses
MARY AMANDA BASHISTA
Board Of Medicine
License number
LRT-914
Date granted
04/22/2002
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
11875 Hemlock Ct. BOISE ID 83709
idaholicensing.com
ID 48337603
LAST UPDATED 2024-05-05 03:12:11 UTC
LAST UPDATED 2024-05-05 03:12:11 UTC
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