License holder summary

MICHAEL JAMES GUSTAVEL is a Board Of Medicine licensed to practice in Idaho. The address on file for MICHAEL JAMES GUSTAVEL is 1188 University Dr BOISE ID 83706. This licensed professional license is current. The license was granted 11/24/2004 and expired on 12/31/2017.

Idaho

Division of Occupational and Professional Licenses

MICHAEL JAMES GUSTAVEL
Board Of Medicine
License number
DPHY-8510
Date granted
11/24/2004
Date expires
12/31/2017
Class
Board Of Medicine
Status
Renewed
Address
1188 University Dr BOISE ID 83706
idaholicensing.com
ID 48339176
LAST UPDATED 2024-03-31 06:59:17 UTC

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