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
2/25/2019 Reinstated
9/8/2017 Type Change
2/22/2017 Renewed
2/23/2016 Renewed
2/18/2015 Renewed
2/20/2014 Renewed
2/22/2013 Renewed
2/24/2012 Renewed
2/28/2011 Renewed
2/22/2010 Renewed
1/29/2009 Renewed
9/27/2007 New License
 
Disciplinary Action Documents
 
None
 
** Press Close When Done **
 

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.