PHILIP CLARKE BLUM
Idaho M-8285 Canceled
This Idaho license was held by PHILIP CLARKE BLUM. The license is no longer active. It was granted on 09/08/2001 and expired on 08/01/2016
LICENSE DETAILS
- License Number: M-8285
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 09/08/2001 (over 23 years ago)
- Expiry Date: 08/01/2016 (over 8 years ago)
LOCATIONS
A Residential
PO BOX 13215 JACKSON WY 83002