MARK S RIDLEN MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125013970

License Status

EXPIRED

Business

First Name

MARK S

Last Name

RIDLEN

Suffix

Business Name

MARK S RIDLEN MD

Original Issue Date

06/17/1982

Effective Date

06/17/1982

Expiration Date

07/01/1984

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/22/2006