License holder summary

MIA DIANE GROTH PIPKIN is a Board Of Medicine licensed to practice in Idaho. The address on file for MIA DIANE GROTH PIPKIN is 5439 Cynthia Street Coeur d Alene ID 83815. This licensed professional license is not current. The license was granted 10/05/2001 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

MIA DIANE GROTH PIPKIN
Board Of Medicine
License number
LRT-892
Date granted
10/05/2001
Date expires
06/30/2017
Class
Board Of Medicine
Status
Reinstated
Address
5439 Cynthia Street Coeur d Alene ID 83815
idaholicensing.com
ID 48354789
LAST UPDATED 2024-05-02 12:07:45 UTC

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