SUSAN LYNN BARDOLPH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

ACTIVE

Business

First Name

SUSAN

Middle

LYNN

Last Name

BARDOLPH

Suffix

Business Name

SUSAN LYNN BARDOLPH MD

Original Issue Date

08/28/2017

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

WINFIELD

State

Zip

60190

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/21/2023