License holder summary

GANNON BRANDT RANDOLPH is a Board Of Medicine licensed to practice in Idaho. The address on file for GANNON BRANDT RANDOLPH is 1075 N Curtis Road BOISE ID 83706. This licensed professional license is not current. The license was granted 05/10/2006 and expired on 07/31/2010.

Idaho

Division of Occupational and Professional Licenses

GANNON BRANDT RANDOLPH
Board Of Medicine
License number
M-9579
Date granted
05/10/2006
Date expires
07/31/2010
Class
Board Of Medicine
Status
Canceled
Address
1075 N Curtis Road BOISE ID 83706
idaholicensing.com
ID 48345724
LAST UPDATED 2024-02-07 14:09:24 UTC

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