COLIN NEIL BOMSTAD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125085181

License Status

ACTIVE

Business

Title

First Name

COLIN

Middle

NEIL

Last Name

BOMSTAD

Business Name

COLIN NEIL BOMSTAD MD

Original Issue Date

07/01/2025

Effective Date

07/01/2025

Expiration Date

06/30/2028

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/09/2025