ALEXIS C BOUTENEFF MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036147133

License Status

NOT RENEWED

Business

Title

First Name

ALEXIS

Middle

Last Name

BOUTENEFF

Business Name

ALEXIS C BOUTENEFF MD

Original Issue Date

08/07/2018

Effective Date

08/07/2018

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

01/14/2021