SAMANTHA ANN DICUS
Idaho AT-450 Canceled
This Idaho license was held by SAMANTHA ANN DICUS. The license is no longer active. It was granted on 11/16/2012 and expired on 08/01/2013
LICENSE DETAILS
- License Number: AT-450
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 11/16/2012 (over 12 years ago)
- Expiry Date: 08/01/2013 (over 11 years ago)
LOCATIONS
A Residential
2401 E GREEN CANYON DR MERIDIAN ID 83642