ENRIQUE V BOUFFARD III MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036054461

License Status

NOT RENEWED

Business

First Name

ENRIQUE

Middle

Last Name

BOUFFARD

Suffix

III MD

Business Name

ENRIQUE V BOUFFARD III MD

Original Issue Date

04/14/1977

Effective Date

05/09/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60611

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017