JAY BOUGHANEM MD - Medical Doctor License in Illinois | # 125049002

JAY BOUGHANEM MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049002

License Status

CANCELLED

Business

N

First Name

JAY

Last Name

BOUGHANEM

Suffix

MD

Business Name

JAY BOUGHANEM MD

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/19/2008

State

IL

Ever Disciplined

N

LastModifiedDate

06/10/2011