License holder summary

SHAD CARL JOHNSON is a Board Of Medicine licensed to practice in Idaho. The address on file for SHAD CARL JOHNSON is 1151 Hospital Way Bldg A Pocatello ID 83201. This licensed professional license is current. The license was granted 09/22/2006 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

SHAD CARL JOHNSON
Board Of Medicine
License number
PA-629
Date granted
09/22/2006
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1151 Hospital Way Bldg A Pocatello ID 83201
idaholicensing.com
ID 48352884
LAST UPDATED 2024-02-24 01:19:24 UTC

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