KEVIN P BOLAND DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054454

License Status

CANCELLED

Business

Title

First Name

KEVIN

Middle

Last Name

BOLAND

Business Name

KEVIN P BOLAND DO

Original Issue Date

07/01/2008

Effective Date

07/01/2008

Expiration Date

06/30/2011

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/30/2008