Idaho
Division of Occupational and Professional Licenses
TESSA ANN POULSEN
Board Of Medicine
License number
PA-1002
Date granted
09/27/2012
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1309 BENNETT AVE BURLEY ID 83318
idaholicensing.com
ID 48357728
LAST UPDATED 2024-04-27 18:50:46 UTC
LAST UPDATED 2024-04-27 18:50:46 UTC
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