Idaho
Division of Occupational and Professional Licenses
SHANE ALEXANDER ANDREW
Board Of Medicine
License number
O-0443
Date granted
04/27/2007
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
4400 E. Flamingo Ave. Nampa ID 83687
idaholicensing.com
ID 48336741
LAST UPDATED 2024-04-29 12:04:18 UTC
LAST UPDATED 2024-04-29 12:04:18 UTC
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