RIDA W BOULOS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036055246

License Status

ACTIVE

Business

First Name

RIDA W

Last Name

BOULOS

Suffix

Business Name

RIDA W BOULOS MD

Original Issue Date

08/11/1977

Effective Date

07/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61604

County

PEORIA

Ever Disciplined

LastModifiedDate

07/08/2023