License holder summary

KELLY ANN HANSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for KELLY ANN HANSEN is 1832 Earle St Klamath Falls OR 97601. This licensed professional license is not current. The license was granted 12/21/1994 and expired on 07/02/2002.

Idaho

Division of Occupational and Professional Licenses

KELLY ANN HANSEN
Board Of Medicine
License number
D-129
Date granted
12/21/1994
Date expires
07/02/2002
Class
Board Of Medicine
Status
Canceled
Address
1832 Earle St Klamath Falls OR 97601
idaholicensing.com
ID 48360696
LAST UPDATED 2024-02-07 21:25:14 UTC

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