MARK S RIDLEN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

MARK S

Last Name

RIDLEN

Suffix

Business Name

MARK S RIDLEN MD

Original Issue Date

09/29/1983

Effective Date

09/29/1983

Expiration Date

07/31/1987

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2017