MATTHEW MARK JOHNSON
Idaho AT-214 Canceled
This Idaho license was held by MATTHEW MARK JOHNSON. The license is no longer active. It was granted on 04/25/2003 and expired on 06/30/2013
LICENSE DETAILS
- License Number: AT-214
- Category: Board Of Medicine
- Status: Canceled
- Date Granted: 04/25/2003 (about 22 years ago)
- Expiry Date: 06/30/2013 (almost 12 years ago)
LOCATIONS
A Residential
442 N. Kensington LA GRANGE PARK IL 60526