License holder summary

TARA ANNE KISHPAUGH is a Board Of Medicine licensed to practice in Idaho. The address on file for TARA ANNE KISHPAUGH is 574 N. Park Ln. EAGLE ID 83616. This licensed professional license is current. The license was granted 04/21/2006 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

TARA ANNE KISHPAUGH
Board Of Medicine
License number
AT-280
Date granted
04/21/2006
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
574 N. Park Ln. EAGLE ID 83616
idaholicensing.com
ID 48338676
LAST UPDATED 2024-04-25 21:30:03 UTC

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