CHARLES S VANDYKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

CHARLES S

Last Name

VANDYKE

Suffix

Business Name

CHARLES S VANDYKE MD

Original Issue Date

01/01/1997

Effective Date

08/27/2020

Expiration Date

07/31/2023

City

PEORIA

State

Zip

61614

County

TAZEWELL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023