Idaho
Division of Occupational and Professional Licenses
SIS E. OSTOLASA
Board Of Medicine
License number
PA-386
Date granted
02/04/2002
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
3025 West Cherry Ln Meridian ID 83642
idaholicensing.com
ID 48361577
LAST UPDATED 2026-04-02 16:45:04 UTC
LAST UPDATED 2026-04-02 16:45:04 UTC
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