MICHAEL S BOEDEFELD - Medical Doctor License in Illinois | # 130000572

MICHAEL S BOEDEFELD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000572

License Status

EXPIRED

Business

N

First Name

MICHAEL

Middle

S

Last Name

BOEDEFELD

Business Name

MICHAEL S BOEDEFELD

Original Issue Date

06/02/2003

Effective Date

06/02/2003

Expiration Date

03/09/2003

State

IL

Specialty/Qualifier

Anesthesiology

Ever Disciplined

N

LastModifiedDate

09/25/2006