PAUL MILES MACMAHON MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063104

License Status

EXPIRED

Business

Title

First Name

PAUL

Middle

MILES

Last Name

MACMAHON

Business Name

PAUL MILES MACMAHON MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2020

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

11/19/2020