Idaho
Division of Occupational and Professional Licenses
TIANA JACOBSEN
Board Of Medicine
License number
RTS-342
Date granted
09/08/2010
Date expires
09/15/2012
Class
Board Of Medicine
Status
Expired
Address
1910 UNIVERSITY DRIVE BOISE ID 83725
idaholicensing.com
ID 48329419
LAST UPDATED 2024-02-13 12:52:25 UTC
LAST UPDATED 2024-02-13 12:52:25 UTC
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