Idaho
Division of Occupational and Professional Licenses
NGASSA A MSSIKA
Board Of Medicine
License number
PAT-705
Date granted
07/28/2009
Date expires
10/09/2009
Class
Board Of Medicine
Status
Expired
Address
555 FLORIDA AVE #2 PORTSMOUTH VA 23707
idaholicensing.com
ID 48354384
LAST UPDATED 2026-03-13 23:47:54 UTC
LAST UPDATED 2026-03-13 23:47:54 UTC
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