TIMOTHY WILLIAM HUISKEN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

CANCELLED

Business

First Name

TIMOTHY

Middle

WILLIAM

Last Name

HUISKEN

Suffix

Business Name

TIMOTHY WILLIAM HUISKEN MD

Original Issue Date

01/06/1999

Effective Date

01/06/1999

Expiration Date

07/31/2002

City

SCOTT AFB

State

Zip

62225

County

SAINT CLAIR

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006