Idaho
Division of Occupational and Professional Licenses
SAMANTHA ANN DICUS
Board Of Medicine
License number
AT-450
Date granted
11/16/2012
Date expires
08/01/2013
Class
Board Of Medicine
Status
Canceled
Address
2401 E GREEN CANYON DR MERIDIAN ID 83642
idaholicensing.com
ID 48344604
LAST UPDATED 2024-02-11 07:46:57 UTC
LAST UPDATED 2024-02-11 07:46:57 UTC
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