License holder summary

KIM O JOHNSON is a Board Of Medicine licensed to practice in Idaho. The address on file for KIM O JOHNSON is 6195 E Sunnyside Rd IDAHO FALLS ID 83406. This licensed professional license is not current. The license was granted 01/13/1964 and expired on 08/03/2015.

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 2026-04-03 00:56:06 UTC

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