TIMOTHY RYAN WHITEHEAD MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125052720

License Status

CANCELLED

Business

Title

First Name

TIMOTHY

Middle

RYAN

Last Name

WHITEHEAD

Business Name

TIMOTHY RYAN WHITEHEAD MD

Original Issue Date

07/01/2011

Effective Date

07/01/2011

Expiration Date

06/30/2013

City

EAST PEORIA

State

Zip

61611

County

TAZEWELL

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

05/23/2011