ALLEN MICHAEL BOOTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036115068

License Status

NOT RENEWED

Business

First Name

ALLEN

Middle

MICHAEL

Last Name

BOOTH

Suffix

Business Name

ALLEN MICHAEL BOOTH MD

Original Issue Date

01/05/2006

Effective Date

05/11/2011

Expiration Date

07/31/2014

City

BISMARCK

State

Zip

58503

County

NORTH DAKOTA

Ever Disciplined

LastModifiedDate

11/17/2014