Idaho
Division of Occupational and Professional Licenses
MICHAEL R MICKELSON
Board Of Medicine
License number
M-4397
Date granted
10/24/1981
Date expires
08/01/2016
Class
Board Of Medicine
Status
Canceled
Address
560 Memorial Dr Pocatello ID 83201
idaholicensing.com
ID 48354056
LAST UPDATED 2024-05-02 00:09:58 UTC
LAST UPDATED 2024-05-02 00:09:58 UTC
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