TODD R RIDENOUR MD FACS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****47

License Status

NOT RENEWED

Business

First Name

TODD R

Last Name

RIDENOUR

Suffix

MD FACS

Business Name

TODD R RIDENOUR MD FACS

Original Issue Date

10/17/1996

Effective Date

10/17/1996

Expiration Date

07/31/2005

City

ROCK ISLAND

State

Zip

61201

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020