DERIC VER NON RAVSTEN

Idaho  O-290   Renewed

This Idaho license is held by DERIC VER NON RAVSTEN. The license is currently active. It was granted on 09/14/2002 and expired on 06/30/2017

LICENSE DETAILS

  • License Number: O-290
  • Category: Board Of Medicine
  • Status: Renewed
  • Date Granted: 09/14/2002 (over 22 years ago)
  • Expiry Date: 06/30/2017 (almost 8 years ago)

LOCATIONS

A Residential

1777 E. Clark St., Suite 330 POCATELLO ID 83201