TRACY R HENDRICKS Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125035708

License Status

EXPIRED

Business

First Name

TRACY

Middle

Last Name

HENDRICKS

Business Name

TRACY R HENDRICKS

Original Issue Date

04/29/1997

Effective Date

04/29/1997

Expiration Date

06/30/2000

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006