License holder summary

STACY SUMIKO CALDWELL is a Board Of Medicine licensed to practice in Idaho. The address on file for STACY SUMIKO CALDWELL is 295 SW SUMMER LAKE DR BEND OR 97702. This licensed professional license is not current. The license was granted 10/11/2007 and expired on 11/09/2007.

Idaho

Division of Occupational and Professional Licenses

STACY SUMIKO CALDWELL
Board Of Medicine
License number
PAT-601
Date granted
10/11/2007
Date expires
11/09/2007
Class
Board Of Medicine
Status
Expired
Address
295 SW SUMMER LAKE DR BEND OR 97702
idaholicensing.com
ID 48335803
LAST UPDATED 2024-03-14 18:41:41 UTC

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