TRACY R HENDRICKS - Medical Doctor License in Illinois | # 125035708

TRACY R HENDRICKS

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035708

License Status

EXPIRED

Business

N

First Name

TRACY

Middle

R

Last Name

HENDRICKS

Business Name

TRACY R HENDRICKS

Original Issue Date

04/29/1997

Effective Date

04/29/1997

Expiration Date

06/30/2000

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006