RONALD F MICIAK
Idaho SPHY-4130 Licensed
This Idaho license is held by RONALD F MICIAK. The license is currently active. It was granted on 06/08/2016 and expired on 12/31/2016
LICENSE DETAILS
- License Number: SPHY-4130
- Category: Board Of Medicine
- Status: Licensed
- Date Granted: 06/08/2016 (almost 8 years ago)
- Expiry Date: 12/31/2016 (over 7 years ago)
LOCATIONS
A Residential
801 Pole Line Rd. West Twin Falls ID 83301
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