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Licenses
Physician
Utah
3387508905
Lee Self
Physician in Gross, ID
License number
Utah 338750-8905
Issued Date
May 27, 1997
Expiration Date
Jan 31, 2018
Category
Physician
Type
Physician/Surgeon CS (Schedule 2-5)
Address
Address
Gross, ID
Physician licenses in Utah
Lee Self
, ,
Gross, ID