License holder summary

SALLY O. FREDERICKS is a Board Of Medicine licensed to practice in Idaho. The address on file for SALLY O. FREDERICKS is 2434 Moscow Mtn Road Moscow ID 83843. This licensed professional license is not current. The license was granted 01/16/1977 and expired on 06/30/1997.

Idaho

Division of Occupational and Professional Licenses

SALLY O. FREDERICKS
Board Of Medicine
License number
M-3568
Date granted
01/16/1977
Date expires
06/30/1997
Class
Board Of Medicine
Status
Canceled
Address
2434 Moscow Mtn Road Moscow ID 83843
idaholicensing.com
ID 48343546
LAST UPDATED 2024-03-19 02:25:10 UTC

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