License holder summary

DR. GARY BLAKE JOHNSON is a Board Of Medicine licensed to practice in Idaho. The address on file for DR. GARY BLAKE JOHNSON is 1060 E 100 S STE 110 SALT LAKE CITY UT 84102. This licensed professional license is not current. The license was granted 05/04/2010 and expired on 08/01/2012.

Idaho

Division of Occupational and Professional Licenses

DR. GARY BLAKE JOHNSON
Board Of Medicine
License number
M-10972
Date granted
05/04/2010
Date expires
08/01/2012
Class
Board Of Medicine
Status
Canceled
Address
1060 E 100 S STE 110 SALT LAKE CITY UT 84102
idaholicensing.com
ID 48352778
LAST UPDATED 2024-03-09 17:44:18 UTC

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