License holder summary

DALLIN JAY JOHANSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for DALLIN JAY JOHANSEN is 124 S 41ST STAPT #2 YAKIMA WA 98901. This licensed professional license is current. The license was granted 05/13/2016 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

DALLIN JAY JOHANSEN
Board Of Medicine
License number
MSO-0198
Date granted
05/13/2016
Date expires
06/30/2017
Class
Board Of Medicine
Status
Licensed
Address
124 S 41ST STAPT #2 YAKIMA WA 98901
idaholicensing.com
ID 48355667
LAST UPDATED 2024-04-10 02:44:28 UTC

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