DANIEL THEODORE BOEDER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****78

License Status

ACTIVE

Business

Title

First Name

DANIEL

Middle

THEODORE

Last Name

BOEDER

Business Name

DANIEL THEODORE BOEDER MD

Original Issue Date

01/18/2024

Effective Date

01/18/2024

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/18/2024