JOAN D BOOMSMA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****15

License Status

NOT RENEWED

Business

First Name

JOAN D

Last Name

BOOMSMA

Suffix

Business Name

JOAN D BOOMSMA MD

Original Issue Date

11/28/1984

Effective Date

06/27/2017

Expiration Date

09/30/2020

City

PORTLAND

State

Zip

04101

County

NEW JERSEY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021