Idaho
Division of Occupational and Professional Licenses
MICHAEL G. BLACKBURN
Board Of Medicine
License number
M-4410
Date granted
10/24/1981
Date expires
07/01/1981
Class
Board Of Medicine
Status
Canceled
Address
214 16th Street Puyallup WA 98371
idaholicensing.com
ID 48329259
LAST UPDATED 2024-04-24 11:48:08 UTC
LAST UPDATED 2024-04-24 11:48:08 UTC
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