License holder summary

RICHARD DALE BLICKENSTAFF is a Board Of Medicine licensed to practice in Idaho. The address on file for RICHARD DALE BLICKENSTAFF is 6454 W Emerald St Boise ID 83704. This licensed professional license is current. The license was granted 10/23/1987 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

RICHARD DALE BLICKENSTAFF
Board Of Medicine
License number
M-5274
Date granted
10/23/1987
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
6454 W Emerald St Boise ID 83704
idaholicensing.com
ID 48334069
LAST UPDATED 2024-02-08 00:45:20 UTC

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