MARY L BOULDIN DR Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036078991

License Status

INACTIVE

Business

First Name

MARY L

Last Name

BOULDIN DR

Business Name

MARY L BOULDIN DR

Original Issue Date

06/09/1989

Effective Date

06/09/1989

Expiration Date

07/31/1993

City

LOUISVILLE

State

Zip

40204

County

KENTUCKY

Ever Disciplined

LastModifiedDate

07/13/2010