PHILIP CHARLES BODENSTAB MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045692

License Status

ACTIVE

Business

First Name

PHILIP CHARLES

Last Name

BODENSTAB

Suffix

Business Name

PHILIP CHARLES BODENSTAB MD

Original Issue Date

06/16/1972

Effective Date

07/18/2023

Expiration Date

07/31/2026

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/18/2023