License holder summary

JACK R. DANIELS is a Board Of Medicine licensed to practice in Idaho. The address on file for JACK R. DANIELS is 1688 Via Isola Monterey CA 93940. This licensed professional license is not current. The license was granted 01/10/1967 and expired on 06/30/1989.

Idaho

Division of Occupational and Professional Licenses

JACK R. DANIELS
Board Of Medicine
License number
M-2762
Date granted
01/10/1967
Date expires
06/30/1989
Class
Board Of Medicine
Status
Canceled
Address
1688 Via Isola Monterey CA 93940
idaholicensing.com
ID 48344693
LAST UPDATED 2024-05-01 14:45:06 UTC

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