MICHAEL G. BLACKBURN
Idaho M-4410 Canceled
This Idaho license was held by MICHAEL G. BLACKBURN. The license is no longer active. It was granted on 10/24/1981 and expired on 07/01/1981
LICENSE DETAILS
- License Number: M-4410
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 10/24/1981 (over 43 years ago)
- Expiry Date: 07/01/1981 (almost 44 years ago)
LOCATIONS
A Residential
214 16th Street Puyallup WA 98371