PHILLIP H PETERSEN

Idaho  SPHY-5405   Renewed

This Idaho license is held by PHILLIP H PETERSEN. The license is currently active. It was granted on 09/06/1988 and expired on 12/31/2016

LICENSE DETAILS

  • License Number: SPHY-5405
  • Category: Board Of Medicine
  • Status: Renewed
  • Date Granted: 09/06/1988 (over 35 years ago)
  • Expiry Date: 12/31/2016 (over 7 years ago)

LOCATIONS

A Residential

301 Cedar Orofino ID 83544