SAMANTHA JANE PORTENIER
Idaho MRM-507 Canceled
This Idaho license was held by SAMANTHA JANE PORTENIER. The license is no longer active. It was granted on 06/30/1997 and expired on 07/23/1998
LICENSE DETAILS
- License Number: MRM-507
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 06/30/1997 (almost 27 years ago)
- Expiry Date: 07/23/1998 (almost 26 years ago)
LOCATIONS
A Residential
315 E ELM ST #100 CALDWELL ID 83605