License holder summary

CARLA JENE SOUTHWICK is a Board Of Medicine licensed to practice in Idaho. The address on file for CARLA JENE SOUTHWICK is 1432 SUMMER PL JEROME ID 83338. This licensed professional license is current. The license was granted 10/05/2015 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

CARLA JENE SOUTHWICK
Board Of Medicine
License number
AT-565
Date granted
10/05/2015
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1432 SUMMER PL JEROME ID 83338
idaholicensing.com
ID 48353778
LAST UPDATED 2024-04-13 04:41:28 UTC

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