JAY BOUGHANEM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036120773

License Status

NOT RENEWED

Business

First Name

JAY

Last Name

BOUGHANEM

Suffix

Business Name

JAY BOUGHANEM MD

Original Issue Date

05/02/2008

Effective Date

05/02/2008

Expiration Date

07/31/2011

City

ROXBURY CROSSING

State

Zip

02120

Ever Disciplined

LastModifiedDate

11/14/2011