Idaho
Division of Occupational and Professional Licenses
MELISSA MACKLEY DAVENPORT
Board Of Medicine
License number
PA-976
Date granted
05/15/2012
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
167 E 1ST SOUTH RIGBY ID 83442
idaholicensing.com
ID 48338968
LAST UPDATED 2024-04-07 09:05:35 UTC
LAST UPDATED 2024-04-07 09:05:35 UTC
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