Idaho
Division of Occupational and Professional Licenses
RICKY DWAYNE LATHAM
Board Of Medicine
License number
M-6887
Date granted
12/02/1995
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
North Bend Medical Clinic Coos Bay OR 97420
idaholicensing.com
ID 48338279
LAST UPDATED 2024-03-09 04:13:18 UTC
LAST UPDATED 2024-03-09 04:13:18 UTC
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