VAN B BOGGUS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125015107

License Status

EXPIRED

Business

First Name

VAN

Middle

Last Name

BOGGUS

Business Name

VAN B BOGGUS

Original Issue Date

12/20/1982

Effective Date

12/20/1982

Expiration Date

01/01/1985

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Orthopaedic Surgery

Ever Disciplined

LastModifiedDate

09/22/2006