Idaho
Division of Occupational and Professional Licenses
JERRY J. HOLLENBECK
Board Of Medicine
License number
TRT-213
Date granted
04/29/2003
Date expires
04/29/2004
Class
Board Of Medicine
Status
Canceled
Address
1521 E. Gilbert Ave. Coeur d Alene ID 83815
idaholicensing.com
ID 48343619
LAST UPDATED 2024-02-26 05:05:31 UTC
LAST UPDATED 2024-02-26 05:05:31 UTC
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