License holder summary

MARK DALE JOHNSON is a Board Of Medicine licensed to practice in Idaho. The address on file for MARK DALE JOHNSON is 4992 Pinehill Dr. Salt Lake City UT 84107. This licensed professional license is not current. The license was granted 02/02/1991 and expired on 07/02/1993.

Idaho

Division of Occupational and Professional Licenses

MARK DALE JOHNSON
Board Of Medicine
License number
M-5794
Date granted
02/02/1991
Date expires
07/02/1993
Class
Board Of Medicine
Status
Canceled
Address
4992 Pinehill Dr. Salt Lake City UT 84107
idaholicensing.com
ID 48352846
LAST UPDATED 2024-02-05 15:15:13 UTC

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