TIMOTHY PATRICK CARROLL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075812

License Status

CANCELLED

Business

Title

First Name

TIMOTHY

Middle

PATRICK

Last Name

CARROLL

Business Name

TIMOTHY PATRICK CARROLL MD

Original Issue Date

06/26/2020

Effective Date

06/26/2020

Expiration Date

06/25/2023

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/20/2020