License holder summary

JESSICA RAE JOHNSON is a Board Of Medicine licensed to practice in Idaho. The address on file for JESSICA RAE JOHNSON is 481 Freeze out Ln Deer Lodge MT 59722. This licensed professional license is not current. The license was granted 06/19/2000 and expired on 07/02/2002.

Idaho

Division of Occupational and Professional Licenses

JESSICA RAE JOHNSON
Board Of Medicine
License number
LRT-822
Date granted
06/19/2000
Date expires
07/02/2002
Class
Board Of Medicine
Status
Canceled
Address
481 Freeze out Ln Deer Lodge MT 59722
idaholicensing.com
ID 48352800
LAST UPDATED 2024-04-06 09:43:18 UTC

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