CHANTAL D HENDERSON 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

CHANTAL D

Last Name

HENDERSON

Suffix

Business Name

CHANTAL D HENDERSON MD

Original Issue Date

10/29/1992

Effective Date

10/29/1992

Expiration Date

07/31/1996

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006