ANN MARIE BLACK

Idaho  D-447   Canceled

This Idaho license was held by ANN MARIE BLACK. The license is no longer active. It was granted on 08/25/2004 and expired on 08/01/2014

LICENSE DETAILS

  • License Number: D-447
  • Category: Board Of Medicine
  • Status: Canceled
  • Date Granted: 08/25/2004 (over 20 years ago)
  • Expiry Date: 08/01/2014 (over 10 years ago)

LOCATIONS

A Residential

2435 S 2010 E SAINT GEORGE UT 84790