DAVID A DODGIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****63

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

DODGIN

Suffix

Business Name

DAVID A DODGIN MD

Original Issue Date

07/06/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011