License holder summary

REBECCA HOLMAN VAN DE VORD is a Board Of Medicine licensed to practice in Idaho. The address on file for REBECCA HOLMAN VAN DE VORD is 3317 12th St Lewiston ID 83501. This licensed professional license is not current. The license was granted 10/29/1996 and expired on 06/30/2003.

Idaho

Division of Occupational and Professional Licenses

REBECCA HOLMAN VAN DE VORD
Board Of Medicine
License number
D-248
Date granted
10/29/1996
Date expires
06/30/2003
Class
Board Of Medicine
Status
Canceled
Address
3317 12th St Lewiston ID 83501
idaholicensing.com
ID 48381826
LAST UPDATED 2024-01-26 03:38:47 UTC

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