STACEY R DEAN
Idaho M-3982 Surrendered
This Idaho license was held by STACEY R DEAN. The license is no longer active. It was granted on 07/20/1979
LICENSE DETAILS
- License Number: M-3982
- Category: Board Of Medicine
- Status: Surrendered
- Date Granted: 07/20/1979 (over 44 years ago)
LOCATIONS
A Residential
GRAND AVE MEDICAL CORVALLIS OR 97330