License holder summary

JACK S BLAISDELL is a Board Of Medicine licensed to practice in Idaho. The address on file for JACK S BLAISDELL is 142 County Rd 216 Durango CO 81301. This licensed professional license is not current. The license was granted 07/15/1973 and expired on 07/02/1991.

Idaho

Division of Occupational and Professional Licenses

JACK S BLAISDELL
Board Of Medicine
License number
M-3176
Date granted
07/15/1973
Date expires
07/02/1991
Class
Board Of Medicine
Status
Canceled
Address
142 County Rd 216 Durango CO 81301
idaholicensing.com
ID 48334846
LAST UPDATED 2024-04-25 03:18:47 UTC

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