Idaho
Division of Occupational and Professional Licenses
LISA KRISTINA JOHNSON
Board Of Medicine
License number
MRM-707
Date granted
05/01/2002
Class
Board Of Medicine
Status
Canceled
Address
6531 SW CAPITOL HWY PORTLAND OR 97201
idaholicensing.com
ID 48352835
LAST UPDATED 2024-03-27 21:38:36 UTC
LAST UPDATED 2024-03-27 21:38:36 UTC
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