License holder summary

HENRIETTE MERCEDES MATHIS is a Board Of Medicine licensed to practice in Idaho. The address on file for HENRIETTE MERCEDES MATHIS is 4020 S FEDERAL WAY UNIT F101 BOISE ID 83716. This licensed professional license is not current. The license was granted 06/24/2011 and expired on 06/30/2014.

Idaho

Division of Occupational and Professional Licenses

HENRIETTE MERCEDES MATHIS
Board Of Medicine
License number
MRM-1210
Date granted
06/24/2011
Date expires
06/30/2014
Class
Board Of Medicine
Status
Expired
Address
4020 S FEDERAL WAY UNIT F101 BOISE ID 83716
idaholicensing.com
ID 48338318
LAST UPDATED 2024-03-13 13:04:40 UTC

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