Public Record
 
Name:  
Profession:  
Type:  
Number:  
Address Of Record:    
City/State/Zip:  
Country:  
Business Phone:  
Original Date of Issue:  
Registered/Licensed By:  
Status:  
Discipline Status:    
Expiration Date:  
 
Status History
Date Action
5/2/2019 Renewed
4/26/2018 Renewed
4/13/2017 Renewed
4/12/2016 Renewed
4/10/2015 Renewed
4/23/2014 Renewed
4/17/2013 Renewed
4/25/2012 Renewed
4/29/2011 Renewed
5/11/2010 Renewed
4/20/2009 Renewed
4/18/2008 Renewed
4/23/2007 Renewed
4/13/2006 Renewed
4/21/2005 Renewed
4/14/2004 Renewed
6/9/2003 Renewed
6/30/2002 Type Change
6/14/2002 Renewed
6/8/2001 Renewed
 
Disciplinary Action Documents
 
None
 
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NOTE: This document is a copy of the electronic record of the person named above and constitutes a verification of that record. If official certification  of this record is required, a written request must be submitted together with a $10.00 fee to the Bureau of Occupational Licenses, 700 West State Street, PO Box 83720, Boise, Idaho 83720-0063.

 

NOTE: If a disciplinary document is not available on the Documents tab, please fill out and submit a Public Records Request  form.