TIMOTHY WILLIAM MARTIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

WILLIAM

Last Name

MARTIN

Suffix

Business Name

TIMOTHY WILLIAM MARTIN MD

Original Issue Date

02/21/2019

Effective Date

07/14/2020

Expiration Date

07/31/2023

City

EAST DUBUQUE

State

Zip

61025

County

JO DAVIESS

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

11/30/2023