Idaho
Division of Occupational and Professional Licenses
PATRICIA LYNNE DAVENPORT
Board Of Medicine
License number
AT-377
Date granted
08/10/2010
Date expires
08/01/2016
Class
Board Of Medicine
Status
Canceled
Address
6425 N DAVENPORT ST DALTON GDNS ID 83815
idaholicensing.com
ID 48338970
LAST UPDATED 2024-03-20 00:04:16 UTC
LAST UPDATED 2024-03-20 00:04:16 UTC
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