License holder summary

MAKENZIE MARIE BULLOCK is a Board Of Medicine licensed to practice in Idaho. The address on file for MAKENZIE MARIE BULLOCK is 6265 PHEASANT DR LAVA HOT SPRINGS ID 83246. This licensed professional license is not current. The license was granted 09/11/2013 and expired on 08/07/2015.

Idaho

Division of Occupational and Professional Licenses

MAKENZIE MARIE BULLOCK
Board Of Medicine
License number
PAT-1078
Date granted
09/11/2013
Date expires
08/07/2015
Class
Board Of Medicine
Status
Expired
Address
6265 PHEASANT DR LAVA HOT SPRINGS ID 83246
idaholicensing.com
ID 48341913
LAST UPDATED 2024-02-15 13:19:08 UTC

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