BRANDON CHARLES BODAGER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

Title

First Name

BRANDON

Middle

CHARLES

Last Name

BODAGER

Business Name

BRANDON CHARLES BODAGER MD

Original Issue Date

03/25/2023

Effective Date

07/22/2023

Expiration Date

07/31/2026

City

EVANSTON

State

Zip

60202

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/22/2023