TIMOTHY ALAN MIKESELL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****87

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

ALAN

Last Name

MIKESELL

Suffix

Business Name

TIMOTHY ALAN MIKESELL MD

Original Issue Date

05/17/2018

Effective Date

06/30/2020

Expiration Date

07/31/2023

City

SPRINGFIELD

State

Zip

62769

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023