JACQUELINE D HENDERSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****29

License Status

NOT RENEWED

Business

First Name

JACQUELINE

Middle

Last Name

HENDERSON

Suffix

Business Name

JACQUELINE D HENDERSON MD

Original Issue Date

10/28/2002

Effective Date

10/28/2002

Expiration Date

07/31/2008

City

KANKAKEE

State

Zip

60901

County

KANKAKEE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/06/2008