License holder summary

ALAN MICHAEL RUSSELL is a Board Of Medicine licensed to practice in Idaho. The address on file for ALAN MICHAEL RUSSELL is 1006 E Holly St Boise ID 83712. This licensed professional license is not current. The license was granted 07/11/1992.

Idaho

Division of Occupational and Professional Licenses

ALAN MICHAEL RUSSELL
Board Of Medicine
License number
PR-002
Date granted
07/11/1992
Class
Board Of Medicine
Status
Canceled
Address
1006 E Holly St Boise ID 83712
idaholicensing.com
ID 48363732
LAST UPDATED 2024-03-26 17:27:13 UTC

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