TIMOTHY ALAN MIXON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING PHYSICIAN PERMIT

License Number

106000213

License Status

EXPIRED

Business

First Name

TIMOTHY

Middle

ALAN

Last Name

MIXON

Suffix

Business Name

TIMOTHY ALAN MIXON MD

Original Issue Date

10/09/2003

Effective Date

10/09/2003

Expiration Date

04/26/2004

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Ever Disciplined

LastModifiedDate

09/23/2006