License holder summary

DOUGLAS WADE NICOLARSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for DOUGLAS WADE NICOLARSEN is 338 E BANNOCK STREET BOISE ID 83712. This licensed professional license is current. The license was granted 03/25/1992 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

DOUGLAS WADE NICOLARSEN
Board Of Medicine
License number
M-5967
Date granted
03/25/1992
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
338 E BANNOCK STREET BOISE ID 83712
idaholicensing.com
ID 48354105
LAST UPDATED 2026-05-03 16:41:15 UTC

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