License holder summary

TIMOTHY J SULLIVAN is a Board Of Medicine licensed to practice in Idaho. The address on file for TIMOTHY J SULLIVAN is 338 E BANNOCK STREET BOISE ID 83712. This licensed professional license is not current. The license was granted 07/09/1972 and expired on 08/01/2016.

Idaho

Division of Occupational and Professional Licenses

TIMOTHY J SULLIVAN
Board Of Medicine
License number
M-3068
Date granted
07/09/1972
Date expires
08/01/2016
Class
Board Of Medicine
Status
Canceled
Address
338 E BANNOCK STREET BOISE ID 83712
idaholicensing.com
ID 48355469
LAST UPDATED 2023-12-30 05:39:47 UTC

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