AUDREY DEANNE BLACKLOCK
Idaho MRM-0896 Expired
This Idaho license was held by AUDREY DEANNE BLACKLOCK. The license is no longer active. It was granted on 06/22/2006 and expired on 06/27/2007
LICENSE DETAILS
- License Number: MRM-0896
- Category: Board Of Medicine
- Status: Expired
- Date Granted: 06/22/2006 (almost 18 years ago)
- Expiry Date: 06/27/2007 (almost 17 years ago)
LOCATIONS
A Residential
VA MEDICAL CENTER BOISE ID 83702