License holder summary

Mark Edward Kieckbusch is a Medical - Physician And Surgeon licensed to practice in Minnesota. The address on file for Mark Edward Kieckbusch is PO Box 881, Boise, ID 83701-0881. This doctor license is current. The license was granted 05/10/1986 and expired on 06/30/2015.

Department of Safety and Professional Services

Board of Medical Practice

Mark Edward Kieckbusch
Medical - Physician And Surgeon
License number
30012
Date granted
05/10/1986
Date expires
06/30/2015
Class
Medical - Physician And Surgeon
Status
Active
Address
PO Box 881, Boise, ID 83701-0881
doctorsminnesota.org
ID 22235280
LAST UPDATED 2024-04-01 19:22:42 UTC

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