PENNY MICHELLE FAIRES
Idaho M-9861 Canceled
This Idaho license was held by PENNY MICHELLE FAIRES. The license is no longer active. It was granted on 03/21/2007 and expired on 08/01/2008
LICENSE DETAILS
- License Number: M-9861
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 03/21/2007 (about 17 years ago)
- Expiry Date: 08/01/2008 (over 15 years ago)
LOCATIONS
A Residential
7210 ROOSEVELT WAY NE SEATTLE WA 98115