BRIAN WALLACE FORTUIN
Idaho SPHY-7263 Renewed
This Idaho license is held by BRIAN WALLACE FORTUIN. The license is currently active. It was granted on 11/27/2007 and expired on 12/31/2017
LICENSE DETAILS
- License Number: SPHY-7263
- Category: Board Of Medicine
- Status: Renewed
- Date Granted: 11/27/2007 (over 16 years ago)
- Expiry Date: 12/31/2017 (over 6 years ago)
LOCATIONS
A Residential
775 Pole Line Rd West TWIN FALLS ID 83301
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