FREDERICK AUGUSTUS GODLEY IV MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****57

License Status

ACTIVE

Business

Title

First Name

FREDERICK

Middle

AUGUSTUS

Last Name

GODLEY IV

Business Name

FREDERICK AUGUSTUS GODLEY IV MD

Original Issue Date

04/21/2023

Effective Date

04/21/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60637

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/24/2023