MYRON TIMOTHY POTTER II MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041350

License Status

NOT RENEWED

Business

First Name

MYRON TIMOTHY

Last Name

POTTER II

Suffix

Business Name

MYRON TIMOTHY POTTER II MD

Original Issue Date

08/07/1967

Effective Date

08/07/1967

Expiration Date

07/31/2005

City

MAKANDA

State

Zip

62958

County

JACKSON

Ever Disciplined

LastModifiedDate

10/09/2006