License holder summary

RANDALL LEE BIVENS is a Board Of Medicine licensed to practice in Idaho. The address on file for RANDALL LEE BIVENS is 20105 GEISENDORFER APPLEGATE CA 95703. This licensed professional license is current. The license was granted 08/01/1986 and expired on 06/30/2018.

Idaho

Division of Occupational and Professional Licenses

RANDALL LEE BIVENS
Board Of Medicine
License number
M-5114
Date granted
08/01/1986
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
20105 GEISENDORFER APPLEGATE CA 95703
idaholicensing.com
ID 48340844
LAST UPDATED 2026-03-08 02:40:48 UTC

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