KODY GIBSON BOLK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

ACTIVE

Business

Title

First Name

KODY

Middle

GIBSON

Last Name

BOLK

Business Name

KODY GIBSON BOLK MD

Original Issue Date

06/29/2024

Effective Date

06/29/2024

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/24/2026