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 2026-06-29 14:10:40 UTC
LAST UPDATED 2026-06-29 14:10:40 UTC
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