LISA EILEEN ANDERSEN
Idaho PAT-967 Expired
This Idaho license was held by LISA EILEEN ANDERSEN. The license is no longer active. It was granted on 05/29/2012 and expired on 08/03/2012
LICENSE DETAILS
- License Number: PAT-967
- Category: Board Of Medicine
- Status: Expired
- Date Granted: 05/29/2012 (almost 13 years ago)
- Expiry Date: 08/03/2012 (almost 13 years ago)
LOCATIONS
A Residential
3946 NE 67TH AVE PORTLAND OR 97213