Idaho
Division of Occupational and Professional Licenses
STACEY R DEAN
Board Of Medicine
License number
M-3982
Date granted
07/20/1979
Class
Board Of Medicine
Status
Surrendered
Address
GRAND AVE MEDICAL CORVALLIS OR 97330
idaholicensing.com
ID 48344925
LAST UPDATED 2024-01-01 03:48:22 UTC
LAST UPDATED 2024-01-01 03:48:22 UTC
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