TIMOTHY MICHAEL COOGAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000014

License Status

NOT RENEWED

Business

First Name

TIMOTHY MICHAEL

Last Name

COOGAN

Business Name

TIMOTHY MICHAEL COOGAN

Original Issue Date

11/05/1980

Effective Date

11/05/1980

Expiration Date

11/05/1984

City

CHICAGO

State

Zip

60618

County

COOK

Ever Disciplined

LastModifiedDate

09/26/2006