Public Record
Address Of Record:    
Business Phone:  
Original Date of Issue:  
Registered/Licensed By:  
Discipline Status:    
Expiration Date:  
Status History
Date Action
12/18/2018 Renewed
1/5/2018 Renewed
12/28/2016 Renewed
1/5/2016 Renewed
1/14/2015 Renewed
1/16/2014 Renewed
12/26/2012 Renewed
12/27/2011 Renewed
12/10/2010 Renewed
1/26/2010 Renewed
1/20/2010 Expired
12/30/2008 Renewed
1/23/2008 Renewed
1/20/2008 Expired
12/19/2006 Renewed
12/19/2005 Renewed
12/29/2004 Renewed
12/23/2003 Renewed
6/10/2003 Renewed
6/30/2002 Type Change
6/4/2002 Renewed
6/29/2001 Reinstated
7/9/2000 Expired
Disciplinary Action Documents
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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.