RODERICK L MATTICKS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125022357

License Status

EXPIRED

Business

First Name

RODERICK

Middle

Last Name

MATTICKS

Suffix

Business Name

RODERICK L MATTICKS MD

Original Issue Date

05/13/1988

Effective Date

05/13/1988

Expiration Date

07/01/1991

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006