BODHI M ANDERSON Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****41

License Status

ACTIVE

Business

First Name

BODHI

Middle

Last Name

ANDERSON

Business Name

BODHI M ANDERSON

Original Issue Date

07/28/2015

Effective Date

02/09/2026

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60602

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/09/2026