License holder summary

STACI LYNN DAVENPORT is a Board Of Medicine licensed to practice in Idaho. The address on file for STACI LYNN DAVENPORT is 11261 BELLAIRE ST APT D LOMA LINDA CA 92354. This licensed professional license is not current. The license was granted 10/07/2013 and expired on 06/30/2014.

Idaho

Division of Occupational and Professional Licenses

STACI LYNN DAVENPORT
Board Of Medicine
License number
MSM-0352
Date granted
10/07/2013
Date expires
06/30/2014
Class
Board Of Medicine
Status
Expired
Address
11261 BELLAIRE ST APT D LOMA LINDA CA 92354
idaholicensing.com
ID 48338973
LAST UPDATED 2024-05-06 04:34:56 UTC

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