Idaho
Division of Occupational and Professional Licenses
CAROLYN JOY GREEN
Board Of Medicine
License number
PA-1174
Date granted
06/27/2014
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1150 FAIRVIEW AVE FRUITLAND ID 83619
idaholicensing.com
ID 48347018
LAST UPDATED 2026-05-20 20:38:14 UTC
LAST UPDATED 2026-05-20 20:38:14 UTC
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