LUCILLE A FENDRICK Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****81

License Status

ACTIVE

Business

First Name

LUCILLE A

Last Name

FENDRICK

Business Name

LUCILLE A FENDRICK

Original Issue Date

07/25/1995

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023