TIMOTHY M BEATY Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125030884

License Status

EXPIRED

Business

First Name

TIMOTHY M

Last Name

BEATY

Business Name

TIMOTHY M BEATY

Original Issue Date

04/28/1994

Effective Date

04/28/1994

Expiration Date

06/30/1997

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006