KRISTINE SERENA BOULANGER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049018

License Status

EXPIRED

Business

First Name

KRISTINE

Middle

SERENA

Last Name

BOULANGER

Suffix

Business Name

KRISTINE SERENA BOULANGER MD

Original Issue Date

06/20/2005

Effective Date

06/20/2005

Expiration Date

06/19/2006

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006