BRIAN C BOHOLST MD - Medical Doctor License in Illinois | # 125035033

BRIAN C BOHOLST MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035033

License Status

EXPIRED

Business

N

First Name

BRIAN

Middle

C

Last Name

BOHOLST

Suffix

MD

Business Name

BRIAN C BOHOLST MD

Original Issue Date

06/12/1996

Effective Date

06/12/1996

Expiration Date

06/17/1999

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006