MARK L PETERSEN
Idaho M-4885 Canceled
This Idaho license was held by MARK L PETERSEN. The license is no longer active. It was granted on 04/03/1985 and expired on 08/01/2016
LICENSE DETAILS
- License Number: M-4885
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 04/03/1985 (about 40 years ago)
- Expiry Date: 08/01/2016 (almost 9 years ago)
LOCATIONS
A Residential
2940 Balboa Dr Idaho Falls ID 83404