AMY PUDERBAUGH DO Medical Doctor License verification

AMY PUDERBAUGH DO

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036166711

License Status

ACTIVE

Business

Title

First Name

AMY

Last Name

PUDERBAUGH

Business Name

AMY PUDERBAUGH DO

Original Issue Date

08/24/2023

Effective Date

08/24/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

65807

Ever Disciplined

LastModifiedDate

12/06/2024

Case Number

2023011172

Action

Surrender (Relinquish)

Discipline Start Date

12/05/2024

Discipline Reason

physician and surgeon license indefinitely surrendered for a minimum of one year due to failure to disclose May 2022 DEA Surrender on her April 2023 application for Illinois licensure.