License holder summary

BRENNEN S LARSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for BRENNEN S LARSEN is 5332 E BASELINE RD #1021 MESA AZ 85206. This licensed professional license is current. The license was granted 11/08/2016 and expired on 06/30/2018.

Idaho

Division of Occupational and Professional Licenses

BRENNEN S LARSEN
Board Of Medicine
License number
PA-1453
Date granted
11/08/2016
Date expires
06/30/2018
Class
Board Of Medicine
Status
Licensed
Address
5332 E BASELINE RD #1021 MESA AZ 85206
idaholicensing.com
ID 48872284
LAST UPDATED 2024-03-12 09:30:16 UTC

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