License holder summary

JACK FONG CHAN is a Board Of Medicine licensed to practice in Idaho. The address on file for JACK FONG CHAN is 12212 Scully Avenue Saratoga CA 95070. This licensed professional license is not current. The license was granted 07/10/1972.

Idaho

Division of Occupational and Professional Licenses

JACK FONG CHAN
Board Of Medicine
License number
M-3093
Date granted
07/10/1972
Class
Board Of Medicine
Status
Canceled
Address
12212 Scully Avenue Saratoga CA 95070
idaholicensing.com
ID 48343078
LAST UPDATED 2024-02-18 01:26:02 UTC

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