Idaho
Division of Occupational and Professional Licenses
LISA EILEEN ANDERSEN
Board Of Medicine
License number
PAT-967
Date granted
05/29/2012
Date expires
08/03/2012
Class
Board Of Medicine
Status
Expired
Address
3946 NE 67TH AVE PORTLAND OR 97213
idaholicensing.com
ID 48336568
LAST UPDATED 2024-04-03 17:27:33 UTC
LAST UPDATED 2024-04-03 17:27:33 UTC
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