ROBERT L VICKERMAN Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****00

License Status

NOT RENEWED

Business

First Name

ROBERT L

Last Name

VICKERMAN

Business Name

ROBERT L VICKERMAN

Original Issue Date

06/29/1989

Effective Date

06/29/1989

Expiration Date

07/31/2005

City

LENA

State

Zip

61048

County

JO DAVIESS

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006