RUSSELL JEFFREY BODNER MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

ACTIVE

Business

First Name

RUSSELL

Middle

JEFFREY

Last Name

BODNER

Suffix

Business Name

RUSSELL JEFFREY BODNER MD

Original Issue Date

01/29/2001

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

SYCAMORE

State

Zip

60178

County

DEKALB

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023