TIMOTHY E MORTHLAND Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125046146

License Status

EXPIRED

Business

First Name

TIMOTHY

Middle

Last Name

MORTHLAND

Business Name

TIMOTHY E MORTHLAND

Original Issue Date

07/01/2003

Effective Date

07/01/2003

Expiration Date

06/30/2006

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006