RYAN MATTHEW HENDRICKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****36

License Status

NOT RENEWED

Business

Title

First Name

RYAN

Middle

MATTHEW

Last Name

HENDRICKER

Business Name

RYAN MATTHEW HENDRICKER MD

Original Issue Date

06/09/2010

Effective Date

06/27/2017

Expiration Date

09/30/2020

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021