TIMOTHY ALAN MIKESELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036146205

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

ALAN

Last Name

MIKESELL

Suffix

Business Name

TIMOTHY ALAN MIKESELL MD

Original Issue Date

05/17/2018

Effective Date

06/30/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Ever Disciplined

LastModifiedDate

11/30/2023