JOHANNA L DRICKMAN Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

CANCELLED

Business

First Name

JOHANNA L

Last Name

DRICKMAN

Business Name

JOHANNA L DRICKMAN

Original Issue Date

11/06/1989

Effective Date

11/06/1989

Expiration Date

07/31/1990

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006