LISA MARIE MIX
Idaho D-036 Canceled
This Idaho license was held by LISA MARIE MIX. The license is no longer active. It was granted on 12/12/1994 and expired on 07/03/2001
LICENSE DETAILS
- License Number: D-036
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 12/12/1994 (over 29 years ago)
- Expiry Date: 07/03/2001 (almost 23 years ago)
LOCATIONS
A Residential
593 Monte Vista Dr Twin Falls ID 83301