Idaho
Division of Occupational and Professional Licenses
TESSLYN SUZANNE KEIM
Board Of Medicine
License number
PA-1040
Date granted
12/21/2012
Date expires
08/01/2016
Class
Board Of Medicine
Status
Canceled
Address
15159 SE BANNER CT CLACKAMAS OR 97015
idaholicensing.com
ID 48347686
LAST UPDATED 2024-02-27 09:09:31 UTC
LAST UPDATED 2024-02-27 09:09:31 UTC
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