LICENSE CATEGORY
PHYSICIAN
2
LICENSE SUBCATEGORY
PHYSICIAN & SURGEON
56
PHYSICIAN/SURGEON CS
35
TEMPORARY PHYSICIAN & SURGEON
TEMP PHYSICIAN/SURGEON CONT...
1
JURISDICTION
Utah
STATUSES
Superceded
LOCALITIES
West Palm Beach
27
Boynton Beach
3
Dallas
San Antonio
Denver
Grand Junction
Idaho Falls
Sandy
Salt Lake City
Provo
Saint George
Las Vegas
San Diego
Honolulu
Portland
FIRST LETTER
LUANNA BEAUCHAMP
Utah (Idaho Falls) - Physician - Temp Physician/Surgeon Cont Substance Superceded
TY BOLTON ERICKSON