Louisiana
Board of Licensing
BOUDREAUX STACI SIMON
Medical
License number
PA.A10607.RX
Date expires
07/31/2015
Class
Medical
Status
Active
Address
1747 Imperial Boulevard, LAKE CHARLES, LA 70605
louisianalicensing.com
ID 22001853
LAST UPDATED 2026-05-09 07:23:10 UTC
LAST UPDATED 2026-05-09 07:23:10 UTC