JOHN DOUGLAS DICKINSON DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036137513

License Status

NOT RENEWED

Business

Title

First Name

JOHN

Middle

DOUGLAS

Last Name

DICKINSON

Business Name

JOHN DOUGLAS DICKINSON DO

Original Issue Date

03/09/2015

Effective Date

05/10/2017

Expiration Date

09/30/2020

City

NORMAL

State

Zip

61761

County

MCLEAN

Ever Disciplined

LastModifiedDate

01/14/2021