GORDON A BODZIN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****01

License Status

NOT RENEWED

Business

First Name

GORDON

Middle

Last Name

BODZIN

Business Name

GORDON A BODZIN

Original Issue Date

07/28/2004

Effective Date

07/28/2004

Expiration Date

07/31/2005

City

FOOSLAND

State

Zip

61845

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011