License holder summary

Mr. DONELL ALLEN PETERSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for Mr. DONELL ALLEN PETERSEN is 2581 N MONACO WAY MERIDIAN ID 83646. This licensed professional license is current. The license was granted 06/27/2012 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

Mr. DONELL ALLEN PETERSEN
Board Of Medicine
License number
LRT-1641
Date granted
06/27/2012
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
2581 N MONACO WAY MERIDIAN ID 83646
idaholicensing.com
ID 48348767
LAST UPDATED 2024-04-03 18:16:21 UTC

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