Idaho
Division of Occupational and Professional Licenses
MR. SHANE JERALD VLCEK
Board Of Medicine
License number
PA-866
Date granted
09/28/2010
Date expires
08/01/2013
Class
Board Of Medicine
Status
Canceled
Address
PO BOX 9 NAMPA ID 83653
idaholicensing.com
ID 48342979
LAST UPDATED 2024-02-09 17:52:11 UTC
LAST UPDATED 2024-02-09 17:52:11 UTC
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