DANIEL JOHN BOLSTER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

First Name

DANIEL JOHN

Last Name

BOLSTER

Suffix

Business Name

DANIEL JOHN BOLSTER MD

Original Issue Date

12/26/1986

Effective Date

12/26/1986

Expiration Date

07/31/2005

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020