License holder summary

Dr. LISA Marie MULLEN is a Board Of Medicine licensed to practice in Idaho. The address on file for Dr. LISA Marie MULLEN is 777 N. RAYMOND STREET BOISE ID 83704. This licensed professional license is not current. The license was granted 12/27/2012 and expired on 08/03/2015.

Idaho

Division of Occupational and Professional Licenses

Dr. LISA Marie MULLEN
Board Of Medicine
License number
M-11874
Date granted
12/27/2012
Date expires
08/03/2015
Class
Board Of Medicine
Status
Canceled
Address
777 N. RAYMOND STREET BOISE ID 83704
idaholicensing.com
ID 48359638
LAST UPDATED 2024-02-12 06:13:28 UTC

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