STACIE LYNNE JACOBY
Idaho LRT-1068 Canceled
This Idaho license was held by STACIE LYNNE JACOBY. The license is no longer active. It was granted on 08/03/2004 and expired on 08/01/2011
LICENSE DETAILS
- License Number: LRT-1068
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 08/03/2004 (over 20 years ago)
- Expiry Date: 08/01/2011 (over 13 years ago)
LOCATIONS
A Residential
3600 E EMORY AVE Nampa ID 83686