EVELYN Y BOLT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046596

License Status

CANCELLED

Business

Title

First Name

EVELYN

Middle

Last Name

BOLT

Business Name

EVELYN Y BOLT MD

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2007

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006