ELLEN CODY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

Title

First Name

ELLEN

Last Name

CODY

Business Name

ELLEN CODY MD

Original Issue Date

06/28/2022

Effective Date

06/28/2022

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023