Idaho
Division of Occupational and Professional Licenses
TIFFANY LAYNE NICKERSON
Board Of Medicine
License number
PAT-1224
Date granted
09/25/2014
Date expires
08/05/2016
Class
Board Of Medicine
Status
Expired
Address
669 W PEIRSOL ST NAMPA ID 83686
idaholicensing.com
ID 48354094
LAST UPDATED 2024-04-28 13:11:16 UTC
LAST UPDATED 2024-04-28 13:11:16 UTC
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