RONALD A HICKOMBOTTOM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****69

License Status

NOT RENEWED

Business

Title

First Name

RONALD A

Last Name

HICKOMBOTTOM

Business Name

RONALD A HICKOMBOTTOM MD

Original Issue Date

01/03/1983

Effective Date

01/03/1983

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60619

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020