LISA NICHOL TYLER
Idaho M-9107 Canceled
This Idaho license was held by LISA NICHOL TYLER. The license is no longer active. It was granted on 08/26/2004 and expired on 06/30/2005
LICENSE DETAILS
- License Number: M-9107
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 08/26/2004 (about 22 years ago)
- Expiry Date: 06/30/2005 (about 21 years ago)
LOCATIONS
A Residential
102604 E TRIPPLE VISTA DR KENNEWICK WA 99338