License holder summary

ALLAN RANDOLPH SUPAK is a Board Of Medicine licensed to practice in Idaho. The address on file for ALLAN RANDOLPH SUPAK is PO Box 2083 Salmon ID 83467. This licensed professional license is not current. The license was granted 12/05/1998 and expired on 07/02/1999.

Idaho

Division of Occupational and Professional Licenses

ALLAN RANDOLPH SUPAK
Board Of Medicine
License number
M-7651
Date granted
12/05/1998
Date expires
07/02/1999
Class
Board Of Medicine
Status
Canceled
Address
PO Box 2083 Salmon ID 83467
idaholicensing.com
ID 48335413
LAST UPDATED 2024-03-07 17:03:44 UTC

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