Idaho
Division of Occupational and Professional Licenses
DEREK BRIAN LAURITZEN
Board Of Medicine
License number
M-8693
Date granted
12/07/2002
Date expires
07/14/2005
Class
Board Of Medicine
Status
Canceled
Address
1270 PEACH ST SAN LUIS OBISPO CA 93401
idaholicensing.com
ID 48338708
LAST UPDATED 2026-05-02 16:40:04 UTC
LAST UPDATED 2026-05-02 16:40:04 UTC
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