RODERICK L MATTICKS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

First Name

RODERICK

Middle

Last Name

MATTICKS

Suffix

Business Name

RODERICK L MATTICKS MD

Original Issue Date

04/29/2008

Effective Date

06/27/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61615

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020