JENNIFER ANN HICKMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

NOT RENEWED

Business

Title

First Name

JENNIFER

Middle

ANN

Last Name

HICKMAN

Business Name

JENNIFER ANN HICKMAN MD

Original Issue Date

07/21/2015

Effective Date

06/06/2017

Expiration Date

09/30/2020

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021