License holder summary

JEAN PAUL VILLAVICENCIO is a Board Of Medicine licensed to practice in Idaho. The address on file for JEAN PAUL VILLAVICENCIO is PMB 102 Boise ID 83702. This licensed professional license is not current. The license was granted 08/20/2001 and expired on 06/30/2003.

Idaho

Division of Occupational and Professional Licenses

JEAN PAUL VILLAVICENCIO
Board Of Medicine
License number
LRT-879
Date granted
08/20/2001
Date expires
06/30/2003
Class
Board Of Medicine
Status
Canceled
Address
PMB 102 Boise ID 83702
idaholicensing.com
ID 48339261
LAST UPDATED 2024-04-28 07:57:47 UTC

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