License holder summary

SHANE MATTEW PRATT is a Board Of Medicine licensed to practice in Idaho. The address on file for SHANE MATTEW PRATT is 15616 VENUS CT CALDWELL ID 83607. This licensed professional license is not current. The license was granted 02/16/2012 and expired on 08/01/2016.

Idaho

Division of Occupational and Professional Licenses

SHANE MATTEW PRATT
Board Of Medicine
License number
LRT-1603
Date granted
02/16/2012
Date expires
08/01/2016
Class
Board Of Medicine
Status
Canceled
Address
15616 VENUS CT CALDWELL ID 83607
idaholicensing.com
ID 48362452
LAST UPDATED 2024-05-06 17:06:29 UTC

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