License holder summary

MICHAEL D. MANGUM is a Board Of Medicine licensed to practice in Idaho. The address on file for MICHAEL D. MANGUM is 4141 East 109 North Idaho Falls ID 83401. This licensed professional license is not current. The license was granted 04/21/2003 and expired on 07/31/2010.

Idaho

Division of Occupational and Professional Licenses

MICHAEL D. MANGUM
Board Of Medicine
License number
LRT-996
Date granted
04/21/2003
Date expires
07/31/2010
Class
Board Of Medicine
Status
Canceled
Address
4141 East 109 North Idaho Falls ID 83401
idaholicensing.com
ID 48352097
LAST UPDATED 2024-04-12 09:56:55 UTC

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