TIMOTHY MICHAEL MCCULLOCH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036134367

License Status

NOT RENEWED

Business

Title

First Name

TIMOTHY

Middle

MICHAEL

Last Name

MCCULLOCH

Business Name

TIMOTHY MICHAEL MCCULLOCH MD

Original Issue Date

12/26/2013

Effective Date

05/12/2014

Expiration Date

07/31/2017

City

ROCKFORD

State

Zip

61104

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/01/2017