Dr. KELLY ANNE SUPPLE
Idaho M-10134 Surrendered
This Idaho license was held by Dr. KELLY ANNE SUPPLE. The license is no longer active. It was granted on 12/19/2007
LICENSE DETAILS
- License Number: M-10134
- Category: Board Of Medicine
- Status: Surrendered
- Date Granted: 12/19/2007 (over 16 years ago)
LOCATIONS
A Residential
5200 172ND ST NE STE D ARLINGTON WA 98223