BRIAN L BOSTWICK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

ACTIVE

Business

Title

First Name

BRIAN

Middle

Last Name

BOSTWICK

Business Name

BRIAN L BOSTWICK MD

Original Issue Date

04/10/2002

Effective Date

04/08/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/08/2023