ERIC W BOOSE Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105154

License Status

NOT RENEWED

Business

First Name

ERIC

Middle

Last Name

BOOSE

Business Name

ERIC W BOOSE

Original Issue Date

07/10/2001

Effective Date

07/10/2001

Expiration Date

07/31/2002

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

10/09/2006