Idaho
Division of Occupational and Professional Licenses
LANA JO BORGHOLTHAUS
Board Of Medicine
License number
PA-590
Date granted
11/08/2005
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
PHYSICIANS IMMEDIATE CARE CENTER POCATELLO ID 83201
idaholicensing.com
ID 48338508
LAST UPDATED 2024-03-02 14:54:44 UTC
LAST UPDATED 2024-03-02 14:54:44 UTC
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