JOSEPH RICHARD MACKEY MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061794

License Status

CANCELLED

Business

Title

First Name

JOSEPH

Middle

RICHARD

Last Name

MACKEY

Business Name

JOSEPH RICHARD MACKEY MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2016

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Internal Medicine/Pediatrics

Ever Disciplined

LastModifiedDate

03/31/2015