License holder summary

ELLEN LAVERNE CLARK is a Board Of Medicine licensed to practice in Idaho. The address on file for ELLEN LAVERNE CLARK is N 611 19th Street COEUR D ALENE ID 83814. This licensed professional license is current. The license was granted 11/08/1991 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

ELLEN LAVERNE CLARK
Board Of Medicine
License number
LRT-024
Date granted
11/08/1991
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
N 611 19th Street COEUR D ALENE ID 83814
idaholicensing.com
ID 48343659
LAST UPDATED 2024-01-30 10:58:46 UTC

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