ELIZABETH LOUISE BOLEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059063

License Status

CANCELLED

Business

Title

First Name

ELIZABETH

Middle

LOUISE

Last Name

BOLEN

Business Name

ELIZABETH LOUISE BOLEN MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014