ROGER DAVID CUSHMAN

Idaho  PA-719   Canceled

This Idaho license was held by ROGER DAVID CUSHMAN. The license is no longer active. It was granted on 10/31/2007 and expired on 08/01/2013

LICENSE DETAILS

  • License Number: PA-719
  • Category: Board Of Medicine
  • Status: Canceled
  • Date Granted: 10/31/2007 (over 17 years ago)
  • Expiry Date: 08/01/2013 (almost 12 years ago)

LOCATIONS

A Residential

2055 IRENE LANE IDAHO FALLS ID 83404