Idaho
Division of Occupational and Professional Licenses
MICHEAL BRENT JOHNSON
Board Of Medicine
License number
O-0402
Date granted
05/12/2006
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
1620 Northwest Blvd., #202 Coeur D Alene ID 83814
idaholicensing.com
ID 48352855
LAST UPDATED 2024-04-11 22:34:44 UTC
LAST UPDATED 2024-04-11 22:34:44 UTC
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