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
10/7/2019 Renewed
10/5/2018 Renewed
10/6/2017 Renewed
9/29/2016 Renewed
9/28/2015 Renewed
10/17/2014 Renewed
10/16/2014 Expired
9/17/2013 Renewed
10/1/2012 Renewed
11/21/2011 Reinstated
10/16/2011 Expired
9/22/2010 Renewed
2/4/2009 New License
 
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.