LUIS A BOLANOS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125021405

License Status

EXPIRED

Business

First Name

LUIS A

Last Name

BOLANOS

Suffix

Business Name

LUIS A BOLANOS MD

Original Issue Date

06/22/1987

Effective Date

06/22/1987

Expiration Date

07/01/1990

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/22/2006