License holder summary

LISA MARIE MIX is a Board Of Medicine licensed to practice in Idaho. The address on file for LISA MARIE MIX is 593 Monte Vista Dr Twin Falls ID 83301. This licensed professional license is not current. The license was granted 12/12/1994 and expired on 07/03/2001.

Idaho

Division of Occupational and Professional Licenses

LISA MARIE MIX
Board Of Medicine
License number
D-036
Date granted
12/12/1994
Date expires
07/03/2001
Class
Board Of Medicine
Status
Canceled
Address
593 Monte Vista Dr Twin Falls ID 83301
idaholicensing.com
ID 48355474
LAST UPDATED 2026-03-30 22:51:26 UTC

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