License holder summary

PHILLIP BRIAN WHITTENBERG is a Board Of Medicine licensed to practice in Idaho. The address on file for PHILLIP BRIAN WHITTENBERG is 11197 West Fairview Avenue Boise ID 83713. This licensed professional license is not current. The license was granted 03/12/2010 and expired on 08/03/2015.

Idaho

Division of Occupational and Professional Licenses

PHILLIP BRIAN WHITTENBERG
Board Of Medicine
License number
PA-845
Date granted
03/12/2010
Date expires
08/03/2015
Class
Board Of Medicine
Status
Canceled
Address
11197 West Fairview Avenue Boise ID 83713
idaholicensing.com
ID 48360157
LAST UPDATED 2024-02-17 05:41:18 UTC

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