ANDREW STEPHEN BOUTSICARIS MD - Medical Doctor License in Illinois | # 125077394

ANDREW STEPHEN BOUTSICARIS MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077394

License Status

CANCELLED

Business

N

Title

MD

First Name

ANDREW

Middle

STEPHEN

Last Name

BOUTSICARIS

Business Name

ANDREW STEPHEN BOUTSICARIS MD

Original Issue Date

06/22/2021

Effective Date

06/22/2021

Expiration Date

06/21/2024

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

04/07/2021