TIMOTHY L MCCULLOUGH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

ACTIVE

Business

First Name

TIMOTHY

Middle

Last Name

MCCULLOUGH

Suffix

Business Name

TIMOTHY L MCCULLOUGH MD

Original Issue Date

02/19/2010

Effective Date

06/22/2023

Expiration Date

07/31/2026

City

ALTON

State

Zip

62002

County

MADISON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/22/2023