License holder summary

JENNICE MARIE CORDOVA is a Board Of Medicine licensed to practice in Idaho. The address on file for JENNICE MARIE CORDOVA is 3277 E LOUISE DR STE 350 MERIDIAN ID 83642. This licensed professional license is not current. The license was granted 12/01/1999 and expired on 08/01/2012.

Idaho

Division of Occupational and Professional Licenses

JENNICE MARIE CORDOVA
Board Of Medicine
License number
PA-281
Date granted
12/01/1999
Date expires
08/01/2012
Class
Board Of Medicine
Status
Canceled
Address
3277 E LOUISE DR STE 350 MERIDIAN ID 83642
idaholicensing.com
ID 48344242
LAST UPDATED 2024-03-02 16:36:44 UTC

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