TIMOTHY JOSEPH PENN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

First Name

TIMOTHY JOSEPH

Last Name

PENN

Suffix

Business Name

TIMOTHY JOSEPH PENN MD

Original Issue Date

12/19/1995

Effective Date

04/12/2023

Expiration Date

07/31/2026

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/12/2023