PHILLIP DEAN BOREN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036038088

License Status

NOT RENEWED

Business

First Name

PHILLIP DEAN

Last Name

BOREN

Suffix

Business Name

PHILLIP DEAN BOREN MD

Original Issue Date

09/21/1962

Effective Date

07/24/2017

Expiration Date

09/30/2020

City

CARMI

State

Zip

62821

County

WHITE

Ever Disciplined

LastModifiedDate

01/14/2021

Case Number

2009011068

Action

Fine

Discipline Start Date

05/08/2012