BRIAN ROBERT BOULAY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000200

License Status

EXPIRED

Business

First Name

BRIAN

Middle

ROBERT

Last Name

BOULAY

Suffix

Business Name

BRIAN ROBERT BOULAY MD

Original Issue Date

12/15/2003

Effective Date

12/15/2003

Expiration Date

06/14/2004

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

Gastroenterology

Ever Disciplined

LastModifiedDate

09/25/2006