Mr. MATTHEW ZACHARY HUMPHREY
Idaho AT-568 Canceled
This Idaho license was held by Mr. MATTHEW ZACHARY HUMPHREY. The license is no longer active. It was granted on 12/02/2015 and expired on 08/01/2016
LICENSE DETAILS
- License Number: AT-568
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 12/02/2015 (over 8 years ago)
- Expiry Date: 08/01/2016 (over 7 years ago)
LOCATIONS
A Residential
1958 S DIVISION AVE BOISE ID 83706