MICHAEL JAMES BOLLAERT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058662

License Status

CANCELLED

Business

Title

First Name

MICHAEL

Middle

JAMES

Last Name

BOLLAERT

Business Name

MICHAEL JAMES BOLLAERT MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/27/2010