CHARLES S VANDYKE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

CHARLES S

Last Name

VANDYKE

Suffix

Business Name

CHARLES S VANDYKE MD

Original Issue Date

06/15/1984

Effective Date

06/15/1984

Expiration Date

07/31/1987

City

BARTONVILLE

State

Zip

61607

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020