License holder summary

LANCE RUSSELL PETERSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for LANCE RUSSELL PETERSEN is 120 E Howard Ave Driggs ID 83422. This licensed professional license is current. The license was granted 06/08/2007 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

LANCE RUSSELL PETERSEN
Board Of Medicine
License number
M-9976
Date granted
06/08/2007
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
120 E Howard Ave Driggs ID 83422
idaholicensing.com
ID 48348783
LAST UPDATED 2024-02-29 20:51:40 UTC

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