BORIS G KOUSSEFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036056283

License Status

NOT RENEWED

Business

First Name

BORIS G

Last Name

KOUSSEFF

Suffix

Business Name

BORIS G KOUSSEFF MD

Original Issue Date

01/13/1978

Effective Date

01/13/1978

Expiration Date

07/01/1982

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/20/2006