DAVID L BOLSHOUN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102800

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

BOLSHOUN

Suffix

Business Name

DAVID L BOLSHOUN MD

Original Issue Date

06/22/2000

Effective Date

06/22/2000

Expiration Date

07/31/2002

City

ST LOUIS

State

Zip

63123

County

MISSOURI

Ever Disciplined

LastModifiedDate

10/09/2006