JASON PETER BOULWARE DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036155838

License Status

ACTIVE

Business

Title

First Name

JASON

Middle

PETER

Last Name

BOULWARE

Business Name

JASON PETER BOULWARE DO

Original Issue Date

03/01/2021

Effective Date

06/16/2023

Expiration Date

07/31/2026

City

MAPLEWOOD

State

Zip

07040

County

NEW JERSEY

Ever Disciplined

LastModifiedDate

05/02/2025