LUIS A BOLANOS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

LUIS A

Last Name

BOLANOS

Suffix

Business Name

LUIS A BOLANOS MD

Original Issue Date

10/24/1996

Effective Date

07/14/2017

Expiration Date

09/30/2020

City

AURORA

State

Zip

60504

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021