License holder summary

JENNIFER LYNN ELLISON is a Board Of Medicine licensed to practice in Idaho. The address on file for JENNIFER LYNN ELLISON is 6128 S PLATEAU VIEW WAY BOISE ID 83716. This licensed professional license is not current. The license was granted 08/08/2011 and expired on 08/01/2014.

Idaho

Division of Occupational and Professional Licenses

JENNIFER LYNN ELLISON
Board Of Medicine
License number
PGT-091
Date granted
08/08/2011
Date expires
08/01/2014
Class
Board Of Medicine
Status
Canceled
Address
6128 S PLATEAU VIEW WAY BOISE ID 83716
idaholicensing.com
ID 48355180
LAST UPDATED 2024-04-08 00:20:13 UTC

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