MARK DAVID WIGOD
Idaho SPHY-8189 Canceled
This Idaho license was held by MARK DAVID WIGOD. The license is no longer active. It was granted on 08/21/2006 and expired on 01/05/2009
LICENSE DETAILS
- License Number: SPHY-8189
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 08/21/2006 (over 18 years ago)
- Expiry Date: 01/05/2009 (over 16 years ago)
LOCATIONS
A Residential
3630 E LOUISE DR MERIDIAN ID 83642