EDITH IFEOMA HENDERSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

ACTIVE

Business

Title

First Name

EDITH

Middle

IFEOMA

Last Name

HENDERSON

Business Name

EDITH IFEOMA HENDERSON MD

Original Issue Date

07/11/2025

Effective Date

07/11/2025

Expiration Date

07/31/2026

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/11/2025