License holder summary

JACK LAWRENCE UNDERWOOD is a Board Of Medicine licensed to practice in Idaho. The address on file for JACK LAWRENCE UNDERWOOD is 1565 Union Street Schenectady NY 12309. This licensed professional license is not current. The license was granted 12/06/2003 and expired on 06/30/2004.

Idaho

Division of Occupational and Professional Licenses

JACK LAWRENCE UNDERWOOD
Board Of Medicine
License number
M-8958
Date granted
12/06/2003
Date expires
06/30/2004
Class
Board Of Medicine
Status
Canceled
Address
1565 Union Street Schenectady NY 12309
idaholicensing.com
ID 48361137
LAST UPDATED 2024-03-23 02:20:25 UTC

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