GARY L BODIFORD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****31

License Status

NOT RENEWED

Business

Title

First Name

GARY

Middle

Last Name

BODIFORD

Business Name

GARY L BODIFORD MD

Original Issue Date

01/20/2015

Effective Date

01/20/2015

Expiration Date

07/31/2017

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017