License holder summary

Mr. BRENT ANGEL ELLSWORTH is a Board Of Medicine licensed to practice in Idaho. The address on file for Mr. BRENT ANGEL ELLSWORTH is 150 Shoup Suite 17 Idaho Falls ID 83402. This licensed professional license is current. The license was granted 03/02/2010 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

Mr. BRENT ANGEL ELLSWORTH
Board Of Medicine
License number
PA-844
Date granted
03/02/2010
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
150 Shoup Suite 17 Idaho Falls ID 83402
idaholicensing.com
ID 48357500
LAST UPDATED 2024-02-24 04:21:36 UTC

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