TIMOTHY ALAN MIKESELL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125062755

License Status

EXPIRED

Business

First Name

TIMOTHY

Middle

ALAN

Last Name

MIKESELL

Suffix

Business Name

TIMOTHY ALAN MIKESELL MD

Original Issue Date

06/26/2016

Effective Date

06/26/2016

Expiration Date

06/25/2018

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

01/13/2016