GARY MICHAEL HENDRICKS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075827

License Status

CANCELLED

Business

Title

First Name

GARY

Middle

MICHAEL

Last Name

HENDRICKS

Business Name

GARY MICHAEL HENDRICKS MD

Original Issue Date

06/26/2020

Effective Date

06/26/2020

Expiration Date

06/25/2023

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/20/2020