MR. SHANE JERALD VLCEK
Idaho PA-866 Canceled
This Idaho license was held by MR. SHANE JERALD VLCEK. The license is no longer active. It was granted on 09/28/2010 and expired on 08/01/2013
LICENSE DETAILS
- License Number: PA-866
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 09/28/2010 (over 14 years ago)
- Expiry Date: 08/01/2013 (over 11 years ago)
LOCATIONS
A Residential
PO BOX 9 NAMPA ID 83653