BRODIE ANGUS MACKINTOSH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125085849

License Status

ACTIVE

Business

Title

First Name

BRODIE

Middle

ANGUS

Last Name

MACKINTOSH

Business Name

BRODIE ANGUS MACKINTOSH MD

Original Issue Date

06/26/2025

Effective Date

06/26/2025

Expiration Date

06/25/2028

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/17/2025