TRACY R HENDRICKS Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

First Name

TRACY

Middle

Last Name

HENDRICKS

Business Name

TRACY R HENDRICKS

Original Issue Date

06/07/2000

Effective Date

04/17/2023

Expiration Date

07/31/2026

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2023