Idaho
Division of Occupational and Professional Licenses
STANTON CLARK PACKARD
Board Of Medicine
License number
M-9002
Date granted
03/05/2004
Date expires
06/30/1993
Class
Board Of Medicine
Status
Canceled
Address
524 Carson Ave Dumas TX 79029
idaholicensing.com
ID 48329607
LAST UPDATED 2024-03-19 07:51:02 UTC
LAST UPDATED 2024-03-19 07:51:02 UTC
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