MIA DIANE GROTH Respiratory Care Practitioner License verification

Business Entity

NOT RENEWED

License Type

Respiratory Care Practitioner

Description

RESPIRATORY CARE PRACTITIONER

License Number

194003812

License Status

NOT RENEWED

Business

First Name

MIA

Middle

DIANE

Last Name

GROTH

Business Name

MIA DIANE GROTH

Original Issue Date

11/22/1999

Effective Date

12/03/2001

Expiration Date

10/31/2001

City

COEUR D ALENE

State

Zip

83815

County

IDAHO

Ever Disciplined

LastModifiedDate

09/11/2005