BODIE K GODWIN OD Optometrist License verification

Business Entity

CLOSED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****18

License Status

CLOSED

Business

First Name

BODIE

Middle

Last Name

GODWIN

Suffix

Business Name

BODIE K GODWIN OD

Original Issue Date

02/11/2003

Effective Date

03/10/2020

Expiration Date

03/31/2022

City

MOKENA

State

Zip

60448

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

03/10/2020