License holder summary

SOPHEA ROS JOHANSEN is a Board Of Medicine licensed to practice in Idaho. The address on file for SOPHEA ROS JOHANSEN is 7710 HAZARD CENTER DR STE E SAN DIEGO CA 92108. This licensed professional license is not current. The license was granted 04/18/2012 and expired on 08/01/2014.

Idaho

Division of Occupational and Professional Licenses

SOPHEA ROS JOHANSEN
Board Of Medicine
License number
PA-972
Date granted
04/18/2012
Date expires
08/01/2014
Class
Board Of Medicine
Status
Canceled
Address
7710 HAZARD CENTER DR STE E SAN DIEGO CA 92108
idaholicensing.com
ID 48355672
LAST UPDATED 2024-04-28 10:43:56 UTC

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