License holder summary

CHARISSE LEE MACK is a Board Of Medicine licensed to practice in Idaho. The address on file for CHARISSE LEE MACK is 190 E Bannock St. Boise ID 83712. This licensed professional license is not current. The license was granted 08/28/2006.

Idaho

Division of Occupational and Professional Licenses

CHARISSE LEE MACK
Board Of Medicine
License number
GPA-015
Date granted
08/28/2006
Class
Board Of Medicine
Status
Upgraded
Address
190 E Bannock St. Boise ID 83712
idaholicensing.com
ID 48329544
LAST UPDATED 2024-03-15 11:46:43 UTC

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