TIMOTHY EAMON FAHEY MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062151

License Status

EXPIRED

Business

Title

First Name

TIMOTHY

Middle

EAMON

Last Name

FAHEY

Business Name

TIMOTHY EAMON FAHEY MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2017

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

09/19/2017