License holder summary

JEFFERY LYLE JOHNSON is a Board Of Medicine licensed to practice in Idaho. The address on file for JEFFERY LYLE JOHNSON is 5004 ROSSLARE DR Eagle ID 83616. This licensed professional license is current. The license was granted 09/16/2002 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

JEFFERY LYLE JOHNSON
Board Of Medicine
License number
PA-416
Date granted
09/16/2002
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
5004 ROSSLARE DR Eagle ID 83616
idaholicensing.com
ID 48352797
LAST UPDATED 2024-02-17 23:25:43 UTC

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