Idaho
Division of Occupational and Professional Licenses
WIRT A. HINES Jr.
Board Of Medicine
License number
M-3314
Date granted
01/05/1975
Date expires
07/02/1990
Class
Board Of Medicine
Status
Canceled
Address
1151 E. 3900 S. Ste. B-115 Salt Lake City UT 84117
idaholicensing.com
ID 48352435
LAST UPDATED 2026-06-08 00:50:05 UTC
LAST UPDATED 2026-06-08 00:50:05 UTC
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