License holder summary

ALLAN BRODERSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for ALLAN BRODERSEN is 7007 Lael Way Waxhaw NC 28173. This licensed professional license is not current. The license was granted 09/30/1986 and expired on 06/30/2000.

Idaho

Division of Occupational and Professional Licenses

ALLAN BRODERSEN
Board Of Medicine
License number
M-5134
Date granted
09/30/1986
Date expires
06/30/2000
Class
Board Of Medicine
Status
Deceased
Address
7007 Lael Way Waxhaw NC 28173
idaholicensing.com
ID 48341640
LAST UPDATED 2024-04-08 08:53:24 UTC

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