GLENN DAVID BLAISDELL

Idaho  M-3166   Canceled

This Idaho license was held by GLENN DAVID BLAISDELL. The license is no longer active. It was granted on 07/15/1973 and expired on 07/15/1973

LICENSE DETAILS

  • License Number: M-3166
  • Category: Board Of Medicine
  • Status: Canceled
  • Date Granted: 07/15/1973 (almost 52 years ago)
  • Expiry Date: 07/15/1973 (almost 52 years ago)

LOCATIONS

A Residential

850 Boulder Drive Green River WY 82935