AMY KATHLEEN BROCK
Idaho LRT-774 Canceled
This Idaho license was held by AMY KATHLEEN BROCK. The license is no longer active. It was granted on 06/07/1999 and expired on 06/30/2000
LICENSE DETAILS
- License Number: LRT-774
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 06/07/1999 (almost 26 years ago)
- Expiry Date: 06/30/2000 (almost 25 years ago)
LOCATIONS
A Residential
27 S Blue St Walla Walla WA 99362