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IDAHO STATE BOARD OF VETERINARY MEDICINE APPLICATION FOR CONVERSION TO ACTIVE STATUS Return completed form with the appropriate fee s to Idaho State Board of Veterinary Medicine P. O. Box 7249 Boise ID 83707 For Information Call 208 332-8588 or Idaho Relay Service 1-800-377-3529 for Services for the Hearing Impaired Individuals MAKE CHECKS PAYABLE TO THE IDAHO BOARD OF VETERINARY MEDICINE I. APPLICANT IDENTIFYING INFORMATION First Middle Name Last Social Security No* Required I. C. 73-122...
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