Dr. GUILLERMO MODAD
Idaho TLM-4031 Upgraded
This Idaho license was held by Dr. GUILLERMO MODAD. The license is no longer active. It was granted on 06/11/2014 and expired on 06/24/2014
LICENSE DETAILS
- License Number: TLM-4031
- Category: Board Of Medicine
- Status: Upgraded
- Date Granted: 06/11/2014 (almost 11 years ago)
- Expiry Date: 06/24/2014 (almost 11 years ago)
LOCATIONS
A Residential
313 S MONROE ST MOSCOW ID 83843