Idaho
Division of Occupational and Professional Licenses
Dr. EDWARD ALAN LISENBEY
Board Of Medicine
License number
M-12976
Date granted
06/24/2015
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
401 W POPLAR WALLA WALLA WA 99362
idaholicensing.com
ID 48360118
LAST UPDATED 2024-02-23 22:44:09 UTC
LAST UPDATED 2024-02-23 22:44:09 UTC
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