DAVID WARREN BOLDT MD - Medical Doctor License in Illinois | # 125053307

DAVID WARREN BOLDT MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053307

License Status

EXPIRED

Business

N

First Name

DAVID

Middle

WARREN

Last Name

BOLDT

Suffix

MD

Business Name

DAVID WARREN BOLDT MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

State

IL

Specialty/Qualifier

Anesthesiology

Ever Disciplined

N

LastModifiedDate

07/08/2010