MARY L BOULDIN DR Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021107

License Status

EXPIRED

Business

First Name

MARY L

Last Name

BOULDIN DR

Business Name

MARY L BOULDIN DR

Original Issue Date

06/02/1987

Effective Date

06/02/1987

Expiration Date

06/23/1990

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006