BRIAN ROBERT BOULAY MD - Medical Doctor License in Illinois | # 188000200

BRIAN ROBERT BOULAY MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000200

License Status

EXPIRED

Business

N

First Name

BRIAN

Middle

ROBERT

Last Name

BOULAY

Suffix

MD

Business Name

BRIAN ROBERT BOULAY MD

Original Issue Date

12/15/2003

Effective Date

12/15/2003

Expiration Date

06/14/2004

State

IL

Specialty/Qualifier

Gastroenterology

Ever Disciplined

N

LastModifiedDate

09/25/2006