DANIEL THEODORE BOEDER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125073980

License Status

CANCELLED

Business

Title

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

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/30/2023