License holder summary

LARRY VAN GENDEREN is a Board Of Medicine licensed to practice in Idaho. The address on file for LARRY VAN GENDEREN is PO Box 1628 Idaho Falls ID 83403. This licensed professional license is not current. The license was granted 01/07/1975 and expired on 06/30/2004.

Idaho

Division of Occupational and Professional Licenses

LARRY VAN GENDEREN
Board Of Medicine
License number
M-3349
Date granted
01/07/1975
Date expires
06/30/2004
Class
Board Of Medicine
Status
Canceled
Address
PO Box 1628 Idaho Falls ID 83403
idaholicensing.com
ID 48381831
LAST UPDATED 2024-04-21 01:19:03 UTC

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