ERIC W BOOSE - Medical Doctor License in Illinois | # 125039338

ERIC W BOOSE

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039338

License Status

EXPIRED

Business

N

First Name

ERIC

Middle

W

Last Name

BOOSE

Business Name

ERIC W BOOSE

Original Issue Date

06/14/1999

Effective Date

06/14/1999

Expiration Date

06/13/2002

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006