Idaho
Division of Occupational and Professional Licenses
MICHAEL ALLAN HALLSTROM
Board Of Medicine
License number
PAT-1469
Date granted
10/03/2016
Date expires
08/25/2017
Class
Board Of Medicine
Status
Licensed
Address
6000 W POPLAR DR BOISE ID 83704
idaholicensing.com
ID 48357515
LAST UPDATED 2026-03-06 11:16:14 UTC
LAST UPDATED 2026-03-06 11:16:14 UTC
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