WILLIAM T BOULWARE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

WILLIAM T

Last Name

BOULWARE

Suffix

Business Name

WILLIAM T BOULWARE MD

Original Issue Date

10/13/1983

Effective Date

10/13/1983

Expiration Date

07/31/1987

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006