License holder summary

STACIE MARIE MCDONOUGH is a Board Of Medicine licensed to practice in Idaho. The address on file for STACIE MARIE MCDONOUGH is 2817 SWAN AVE NAMPA ID 83687. This licensed professional license is not current. The license was granted 06/13/2012 and expired on 11/01/2013.

Idaho

Division of Occupational and Professional Licenses

STACIE MARIE MCDONOUGH
Board Of Medicine
License number
LRT-1637
Date granted
06/13/2012
Date expires
11/01/2013
Class
Board Of Medicine
Status
CE Extenstion Granted
Address
2817 SWAN AVE NAMPA ID 83687
idaholicensing.com
ID 48342705
LAST UPDATED 2024-02-18 03:09:41 UTC

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