ROBERT JOSEPH BOUCEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

ROBERT JOSEPH

Last Name

BOUCEK

Suffix

Business Name

ROBERT JOSEPH BOUCEK MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2005

City

CHAMPAIGN

State

Zip

61821

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011