The holder whose full name is Johnson, Micheal Brent,come from Coeur D Alene ID,hold the Osteopathic Physician license(NO.02003921A) which status is Active.
| Name | Johnson, Micheal Brent |
|---|---|
| License Number | 02003921A |
| License Type | Osteopathic Physician |
| License Status | Active |
| City | Coeur D Alene |
| State | ID |