License holder summary

LOREN D BLICKENSTAFF is a Board Of Medicine licensed to practice in Idaho. The address on file for LOREN D BLICKENSTAFF is 4215 Country Club Dr Boise ID 83705. This licensed professional license is not current. The license was granted 07/13/1965 and expired on 06/30/2006.

Idaho

Division of Occupational and Professional Licenses

LOREN D BLICKENSTAFF
Board Of Medicine
License number
M-2690
Date granted
07/13/1965
Date expires
06/30/2006
Class
Board Of Medicine
Status
Canceled
Address
4215 Country Club Dr Boise ID 83705
idaholicensing.com
ID 48334068
LAST UPDATED 2024-04-03 21:46:04 UTC

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