DR. MATTHEW ROGER BLACK
Idaho OI-0477 Voided
This Idaho license was held by DR. MATTHEW ROGER BLACK. The license is no longer active. It was granted on 04/23/2008
LICENSE DETAILS
- License Number: OI-0477
- Category: Board Of Medicine
- Status: Voided
- Date Granted: 04/23/2008 (about 16 years ago)
LOCATIONS
A Residential
450 E Main Rexburg ID 83440