Idaho
Division of Occupational and Professional Licenses
KIM O JOHNSON
Board Of Medicine
License number
M-2628
Date granted
01/13/1964
Date expires
08/03/2015
Class
Board Of Medicine
Status
Canceled
Address
6195 E Sunnyside Rd IDAHO FALLS ID 83406
idaholicensing.com
ID 48352824
LAST UPDATED 2024-02-14 14:10:23 UTC
LAST UPDATED 2024-02-14 14:10:23 UTC
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