KELLY SUE BEACH
Idaho PAI-134 Canceled
This Idaho license was held by KELLY SUE BEACH. The license is no longer active. It was granted on 12/28/1993 and expired on 08/01/2009
LICENSE DETAILS
- License Number: PAI-134
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 12/28/1993 (over 31 years ago)
- Expiry Date: 08/01/2009 (almost 16 years ago)
LOCATIONS
A Residential
300 W. Myrtle Street Boise ID 83702