Idaho
Division of Occupational and Professional Licenses
CODY JOE SCRIVNER
Board Of Medicine
License number
PA-1407
Date granted
09/14/2016
Date expires
06/30/2018
Class
Board Of Medicine
Status
Licensed
Address
13262 W ROCHESTER ST BOISE ID 83713
idaholicensing.com
ID 48344454
LAST UPDATED 2024-02-18 12:32:22 UTC
LAST UPDATED 2024-02-18 12:32:22 UTC
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