BRUCE WILLIAM HENDRICKSEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

NOT RENEWED

Business

First Name

BRUCE WILLIAM

Last Name

HENDRICKSEN

Suffix

Business Name

BRUCE WILLIAM HENDRICKSEN MD

Original Issue Date

01/01/1997

Effective Date

06/10/2020

Expiration Date

07/31/2023

City

PLAINFIELD

State

Zip

60585

County

DUPAGE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023