CODY MICHAEL-TY DECK DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036167608

License Status

ACTIVE

Business

Title

First Name

CODY

Middle

MICHAEL-TY

Last Name

DECK

Business Name

CODY MICHAEL-TY DECK DO

Original Issue Date

11/06/2023

Effective Date

11/06/2023

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61605

County

PEORIA

Ever Disciplined

LastModifiedDate

09/25/2023