ERICA LYNNE IBENDAHL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****43

License Status

ACTIVE

Business

Title

First Name

ERICA

Middle

LYNNE

Last Name

IBENDAHL

Business Name

ERICA LYNNE IBENDAHL MD

Original Issue Date

07/12/2018

Effective Date

05/27/2023

Expiration Date

07/31/2026

City

CENTRALIA

State

Zip

62801

County

MARION

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/27/2023