BOSS POVIENG MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075893

License Status

EXPIRED

Business

Title

First Name

BOSS

Last Name

POVIENG

Business Name

BOSS POVIENG MD

Original Issue Date

07/01/2023

Effective Date

07/01/2023

Expiration Date

06/30/2024

City

CHICAGO

State

Zip

60642

County

COOK

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

10/30/2024