JOSEPH EDWIN BOURQUE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****52

License Status

NOT RENEWED

Business

First Name

JOSEPH EDWIN

Last Name

BOURQUE

Suffix

Business Name

JOSEPH EDWIN BOURQUE MD

Original Issue Date

10/15/1984

Effective Date

10/15/1984

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/28/2007