LEO R BOGGS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****99

License Status

NOT RENEWED

Business

First Name

LEO

Middle

Last Name

BOGGS

Suffix

Business Name

LEO R BOGGS MD

Original Issue Date

05/11/2009

Effective Date

04/18/2014

Expiration Date

07/31/2017

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017