License holder summary

STACY JILL WILES is a Board Of Medicine licensed to practice in Idaho. The address on file for STACY JILL WILES is 881 SW CHEHALIS AVE CHEHALIS WA 98532. This licensed professional license is not current. The license was granted 06/14/2004 and expired on 06/30/2005.

Idaho

Division of Occupational and Professional Licenses

STACY JILL WILES
Board Of Medicine
License number
LRT-1057
Date granted
06/14/2004
Date expires
06/30/2005
Class
Board Of Medicine
Status
Canceled
Address
881 SW CHEHALIS AVE CHEHALIS WA 98532
idaholicensing.com
ID 48387950
LAST UPDATED 2024-04-07 03:47:38 UTC

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