DANIEL KARL BODEN Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****01

License Status

NOT RENEWED

Business

First Name

DANIEL

Middle

KARL

Last Name

BODEN

Business Name

DANIEL KARL BODEN

Original Issue Date

12/15/2020

Effective Date

12/15/2020

Expiration Date

01/31/2022

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Specialty/Qualifier

TEACHING INSTITUTION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022