JACE ANTHONY BIRD
Idaho O-0453 Canceled
This Idaho license was held by JACE ANTHONY BIRD. The license is no longer active. It was granted on 08/15/2007 and expired on 07/31/2010
LICENSE DETAILS
- License Number: O-0453
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 08/15/2007 (almost 17 years ago)
- Expiry Date: 07/31/2010 (almost 14 years ago)
LOCATIONS
A Residential
383 W 170 N APT 4 BLACKFOOT ID 83221