TIMOTHY JOSEPH PENN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****20

License Status

NOT RENEWED

Business

First Name

TIMOTHY JOSEPH

Last Name

PENN

Suffix

Business Name

TIMOTHY JOSEPH PENN MD

Original Issue Date

07/12/1996

Effective Date

07/12/1996

Expiration Date

07/31/2008

City

GLEN CARBON

State

Zip

62034

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020