Idaho
Division of Occupational and Professional Licenses
RUSSELL MARTIN KOCEMBA
Board Of Medicine
License number
M-7077
Date granted
09/03/1996
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
3301 N Sawgrass Boise ID 83704
idaholicensing.com
ID 48342776
LAST UPDATED 2024-04-18 15:16:43 UTC
LAST UPDATED 2024-04-18 15:16:43 UTC
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