MICHAEL JAMES GUSTAVEL
Idaho DPHY-8510 Renewed
This Idaho license is held by MICHAEL JAMES GUSTAVEL. The license is currently active. It was granted on 11/24/2004 and expired on 12/31/2017
LICENSE DETAILS
- License Number: DPHY-8510
- Category: Board Of Medicine
- Status: Renewed
- Date Granted: 11/24/2004 (over 19 years ago)
- Expiry Date: 12/31/2017 (over 6 years ago)
LOCATIONS
A Residential
1188 University Dr BOISE ID 83706
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