HUMPHREY CLARKE BOOTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036072262

License Status

NOT RENEWED

Business

First Name

HUMPHREY CLARKE

Last Name

BOOTH

Suffix

Business Name

HUMPHREY CLARKE BOOTH MD

Original Issue Date

01/24/1986

Effective Date

01/24/1986

Expiration Date

07/31/1987

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

09/20/2006