DANIEL LEE BOUWMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

LEE

Last Name

BOUWMAN

Suffix

Business Name

DANIEL LEE BOUWMAN MD

Original Issue Date

02/14/2002

Effective Date

02/14/2002

Expiration Date

07/31/2005

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006