JOSE THOMAS BOLANOS MD - Medical Doctor License in Illinois | # 125033551

JOSE THOMAS BOLANOS MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033551

License Status

EXPIRED

Business

N

First Name

JOSE

Middle

THOMAS

Last Name

BOLANOS

Suffix

MD

Business Name

JOSE THOMAS BOLANOS MD

Original Issue Date

06/24/1995

Effective Date

06/24/1995

Expiration Date

06/30/1998

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006