AGATHA M S BOGARD MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****74

License Status

NOT RENEWED

Business

First Name

AGATHA

Middle

M S

Last Name

BOGARD

Suffix

Business Name

AGATHA M S BOGARD MD

Original Issue Date

04/08/2009

Effective Date

05/20/2014

Expiration Date

07/31/2017

City

FRANKFORT

State

Zip

60423

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020