DAVID CHARLES BOARDMAN DO - Medical Doctor License in Illinois | # 125040264

DAVID CHARLES BOARDMAN DO

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040264

License Status

EXPIRED

Business

N

First Name

DAVID

Middle

CHARLES

Last Name

BOARDMAN

Suffix

DO

Business Name

DAVID CHARLES BOARDMAN DO

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006