GEOFFREY T BOUC MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

LIMITED MEDICAL TEMPORARY PERMIT

License Number

130000296

License Status

EXPIRED

Business

Title

First Name

GEOFFREY

Middle

Last Name

BOUC

Business Name

GEOFFREY T BOUC MD

Original Issue Date

09/05/1995

Effective Date

09/05/1995

Expiration Date

03/09/1996

City

ROCKFORD

State

Zip

61107

County

BOONE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/25/2006