License holder summary

CHARLENE MARIE DEHAVEN is a Board Of Medicine licensed to practice in Idaho. The address on file for CHARLENE MARIE DEHAVEN is Bonner General Immediate Care Ponderay ID 83852. This licensed professional license is current. The license was granted 08/16/2000 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

CHARLENE MARIE DEHAVEN
Board Of Medicine
License number
M-8054
Date granted
08/16/2000
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
Bonner General Immediate Care Ponderay ID 83852
idaholicensing.com
ID 48339145
LAST UPDATED 2024-05-13 00:47:57 UTC

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