Idaho
Division of Occupational and Professional Licenses
(No First Name) R NUMBERS
Board Of Medicine
License number
M-0004
Date granted
06/20/1899
Class
Board Of Medicine
Status
Canceled
Address
214 Hotel Washington Weiser ID
idaholicensing.com
ID 48358282
LAST UPDATED 2026-03-06 23:16:43 UTC
LAST UPDATED 2026-03-06 23:16:43 UTC
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