BRIAN DANIEL BOLTON MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049094

License Status

CANCELLED

Business

First Name

BRIAN

Middle

DANIEL

Last Name

BOLTON

Suffix

Business Name

BRIAN DANIEL BOLTON MD

Original Issue Date

06/20/2008

Effective Date

06/20/2008

Expiration Date

06/19/2009

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Pathology

Ever Disciplined

LastModifiedDate

05/29/2008