MICHAEL JON MATTICE
Idaho M-3921 Canceled
This Idaho license was held by MICHAEL JON MATTICE. The license is no longer active. It was granted on 05/05/1979 and expired on 05/05/1979
LICENSE DETAILS
- License Number: M-3921
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 05/05/1979 (about 46 years ago)
- Expiry Date: 05/05/1979 (about 46 years ago)
LOCATIONS
A Residential
1239 Southwest Wood #J Portland OR 97201