Dr. TRACY ANN MANUCK
Idaho M-11049 Canceled
This Idaho license was held by Dr. TRACY ANN MANUCK. The license is no longer active. It was granted on 06/28/2010 and expired on 08/01/2014
LICENSE DETAILS
- License Number: M-11049
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 06/28/2010 (almost 15 years ago)
- Expiry Date: 08/01/2014 (over 10 years ago)
LOCATIONS
A Residential
30 N 1900 E STE 2B200 SALT LAKE CITY UT 84132