TIMOTHY MICHAEL COOGAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001873

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

MICHAEL

Last Name

COOGAN

Business Name

TIMOTHY MICHAEL COOGAN

Original Issue Date

09/24/2002

Effective Date

01/27/2014

Expiration Date

03/01/2016

City

CARTERVILLE

State

Zip

62918

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

08/27/2018