TIMOTHY CLARK DYKSTRA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036107985

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

CLARK

Last Name

DYKSTRA

Suffix

Business Name

TIMOTHY CLARK DYKSTRA MD

Original Issue Date

10/09/2002

Effective Date

06/30/2008

Expiration Date

07/31/2011

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

11/14/2011