Idaho
Division of Occupational and Professional Licenses
MATTHEW ALLEN PETERSON
Board Of Medicine
License number
LRT-1664
Date granted
10/02/2012
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
634 Southway Ave Lewiston ID 83501
idaholicensing.com
ID 48362301
LAST UPDATED 2024-05-01 13:09:26 UTC
LAST UPDATED 2024-05-01 13:09:26 UTC
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