License holder summary

LISA EILEEN ANDERSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for LISA EILEEN ANDERSEN is 3946 NE 67TH AVE PORTLAND OR 97213. This licensed professional license is not current. The license was granted 05/29/2012 and expired on 08/03/2012.

Idaho

Division of Occupational and Professional Licenses

LISA EILEEN ANDERSEN
Board Of Medicine
License number
PAT-967
Date granted
05/29/2012
Date expires
08/03/2012
Class
Board Of Medicine
Status
Expired
Address
3946 NE 67TH AVE PORTLAND OR 97213
idaholicensing.com
ID 48336568
LAST UPDATED 2024-02-15 01:35:15 UTC

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