DANIEL THEODORE BOEDER MD - Medical Doctor License in Illinois | # 125073980

DANIEL THEODORE BOEDER MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073980

License Status

CANCELLED

Business

N

Title

MD

First Name

DANIEL

Middle

THEODORE

Last Name

BOEDER

Business Name

DANIEL THEODORE BOEDER MD

Original Issue Date

06/26/2023

Effective Date

06/26/2023

Expiration Date

06/25/2024

State

IL

Specialty/Qualifier

Psychiatry

Ever Disciplined

N

LastModifiedDate

05/30/2023