License holder summary

MICHELLE DAWN MICKELSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for MICHELLE DAWN MICKELSEN is 2543 N 4000 W REXBURG ID 83440. This licensed professional license is current. The license was granted 06/09/2014 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

MICHELLE DAWN MICKELSEN
Board Of Medicine
License number
LRT-1788
Date granted
06/09/2014
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
2543 N 4000 W REXBURG ID 83440
idaholicensing.com
ID 48354053
LAST UPDATED 2024-02-10 22:33:26 UTC

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