License holder summary

MR. LOGAN CLAY FREDERICKSON is a Board Of Medicine licensed to practice in Idaho. The address on file for MR. LOGAN CLAY FREDERICKSON is 777 N RAYMOND STREET BOISE ID 83704. This licensed professional license is not current. The license was granted 12/27/2012 and expired on 12/27/2013.

Idaho

Division of Occupational and Professional Licenses

MR. LOGAN CLAY FREDERICKSON
Board Of Medicine
License number
MSM-0212
Date granted
12/27/2012
Date expires
12/27/2013
Class
Board Of Medicine
Status
Expired
Address
777 N RAYMOND STREET BOISE ID 83704
idaholicensing.com
ID 48343548
LAST UPDATED 2024-02-28 08:30:13 UTC

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