CHARLES S BOUCHARD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125017875

License Status

EXPIRED

Business

First Name

CHARLES

Middle

Last Name

BOUCHARD

Suffix

Business Name

CHARLES S BOUCHARD MD

Original Issue Date

06/13/1985

Effective Date

06/13/1985

Expiration Date

06/28/1988

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006