HEATHER A DECKER Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****59

License Status

NOT RENEWED

Business

First Name

HEATHER

Middle

Last Name

DECKER

Business Name

HEATHER A DECKER

Original Issue Date

06/17/2004

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021