TARA POWELL
Idaho PAT-1016 Expired
This Idaho license was held by TARA POWELL. The license is no longer active. It was granted on 08/27/2012 and expired on 08/08/2014
LICENSE DETAILS
- License Number: PAT-1016
- Category: Board Of Medicine
- Status: Expired
- Date Granted: 08/27/2012 (over 12 years ago)
- Expiry Date: 08/08/2014 (over 10 years ago)
LOCATIONS
A Residential
2730 Channing Way Idaho Falls ID 83404