ELLENA LOIS BODDIE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****13

License Status

ACTIVE

Business

Title

First Name

ELLENA

Middle

LOIS

Last Name

BODDIE

Business Name

ELLENA LOIS BODDIE MD

Original Issue Date

07/07/2021

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

SHOREWOOD

State

Zip

60604

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

07/12/2023