MELISSA A BOEHM DO - Medical Doctor License in Illinois | # 125047373

MELISSA A BOEHM DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125047373

License Status

CANCELLED

Business

N

First Name

MELISSA

Middle

A

Last Name

BOEHM

Suffix

DO

Business Name

MELISSA A BOEHM DO

Original Issue Date

07/01/2004

Effective Date

07/01/2004

Expiration Date

06/30/2007

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006