PAUL BOOM JR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060035

License Status

INACTIVE

Business

First Name

PAUL

Last Name

BOOM JR

Suffix

Business Name

PAUL BOOM JR MD

Original Issue Date

02/19/1980

Effective Date

02/19/1980

Expiration Date

07/31/1987

City

PIERRE

State

Zip

57501

County

SOUTH DAKOTA

Ever Disciplined

LastModifiedDate

09/20/2006