TIMOTHY NOEL RIDDELL Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****19

License Status

ACTIVE

Business

First Name

TIMOTHY

Middle

NOEL

Last Name

RIDDELL

Business Name

TIMOTHY NOEL RIDDELL

Original Issue Date

05/17/2016

Effective Date

12/23/2025

Expiration Date

03/01/2028

City

CHICAGO

State

Zip

60611

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/23/2025