BRIAN ROBERT BOULAY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

ACTIVE

Business

First Name

BRIAN

Middle

ROBERT

Last Name

BOULAY

Suffix

Business Name

BRIAN ROBERT BOULAY MD

Original Issue Date

04/28/2010

Effective Date

05/18/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/18/2023