License holder summary

LISA NICHOL TYLER is a Board Of Medicine licensed to practice in Idaho. The address on file for LISA NICHOL TYLER is 102604 E TRIPPLE VISTA DR KENNEWICK WA 99338. This licensed professional license is not current. The license was granted 08/26/2004 and expired on 06/30/2005.

Idaho

Division of Occupational and Professional Licenses

LISA NICHOL TYLER
Board Of Medicine
License number
M-9107
Date granted
08/26/2004
Date expires
06/30/2005
Class
Board Of Medicine
Status
Canceled
Address
102604 E TRIPPLE VISTA DR KENNEWICK WA 99338
idaholicensing.com
ID 48372968
LAST UPDATED 2024-05-15 17:21:32 UTC

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