Idaho
Division of Occupational and Professional Licenses
THEODORE JAMES CHASE
Board Of Medicine
License number
PA-577
Date granted
10/06/2005
Date expires
08/01/2008
Class
Board Of Medicine
Status
Canceled
Address
PO BOX 1412 MILES CITY MT 59301
idaholicensing.com
ID 48337720
LAST UPDATED 2026-06-02 21:12:25 UTC
LAST UPDATED 2026-06-02 21:12:25 UTC
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