CHARLES S BOUCHARD MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****30

License Status

ACTIVE

Business

First Name

CHARLES

Middle

Last Name

BOUCHARD

Suffix

Business Name

CHARLES S BOUCHARD MD

Original Issue Date

03/12/1991

Effective Date

07/26/2023

Expiration Date

07/31/2026

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

07/26/2023