License holder summary

SHANNON AUTRY JACKSON is a Board Of Medicine licensed to practice in Idaho. The address on file for SHANNON AUTRY JACKSON is PO Box 3404 KETCHUM ID 83340. This licensed professional license is current. The license was granted 02/08/1995 and expired on 06/30/2017.

Idaho

Division of Occupational and Professional Licenses

SHANNON AUTRY JACKSON
Board Of Medicine
License number
D-207
Date granted
02/08/1995
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
PO Box 3404 KETCHUM ID 83340
idaholicensing.com
ID 48329387
LAST UPDATED 2024-02-28 21:48:19 UTC

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