License holder summary

LAWRENCE ESTEL BANTA is a Board Of Medicine licensed to practice in Idaho. The address on file for LAWRENCE ESTEL BANTA is 1906 Fairview Ave Ste 200 CALDWELL ID 83605. This licensed professional license is current. The license was granted 06/26/1987 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

LAWRENCE ESTEL BANTA
Board Of Medicine
License number
M-5243
Date granted
06/26/1987
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1906 Fairview Ave Ste 200 CALDWELL ID 83605
idaholicensing.com
ID 48336836
LAST UPDATED 2024-03-27 10:36:51 UTC

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