ERIC W BOOSE Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

CANCELLED

Business

First Name

ERIC

Middle

Last Name

BOOSE

Business Name

ERIC W BOOSE

Original Issue Date

04/25/2002

Effective Date

04/25/2002

Expiration Date

07/31/2005

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006