PHILLIP DEAN BOREN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

NOT RENEWED

Business

First Name

PHILLIP DEAN

Last Name

BOREN

Suffix

Business Name

PHILLIP DEAN BOREN MD

Original Issue Date

01/01/1997

Effective Date

07/31/2014

Expiration Date

07/31/2017

City

CARMI

State

Zip

62821

County

WHITE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020