Idaho
Division of Occupational and Professional Licenses
TIA MARIE NOWACKI
Board Of Medicine
License number
AT-494
Date granted
11/13/2013
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
405 WEST VILLAGE LANE BOISE ID 83702
idaholicensing.com
ID 48329597
LAST UPDATED 2024-02-06 19:41:26 UTC
LAST UPDATED 2024-02-06 19:41:26 UTC
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