MARTHA ANN STACY Clinical Psychologist License verification

Business Entity

INACTIVE

License Type

Clinical Psychologist

Description

CLINICAL PSYCHOLOGIST

License Number

071005387

License Status

INACTIVE

Business

First Name

MARTHA ANN

Last Name

STACY

Business Name

MARTHA ANN STACY

Original Issue Date

03/26/1997

Effective Date

08/28/2002

Expiration Date

09/30/2002

City

BOISE

State

Zip

83712

County

IDAHO

Ever Disciplined

LastModifiedDate

09/11/2005