Idaho
Division of Occupational and Professional Licenses
MICHAEL G. HENDERSON
Board Of Medicine
License number
PA-491
Date granted
02/26/2004
Date expires
08/01/2008
Class
Board Of Medicine
Status
Canceled
Address
1919 EAST 3060 SOUTH SALT LAKE CITY UT 84106
idaholicensing.com
ID 48352307
LAST UPDATED 2024-03-13 05:43:15 UTC
LAST UPDATED 2024-03-13 05:43:15 UTC
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