ALAIN ROBERT BOUCKENOOGHE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

ALAIN ROBERT

Last Name

BOUCKENOOGHE

Suffix

Business Name

ALAIN ROBERT BOUCKENOOGHE MD

Original Issue Date

05/02/1995

Effective Date

05/02/1995

Expiration Date

07/31/1999

City

FAIRBURY

State

Zip

61739

County

LIVINGSTON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006