TIMOTHY MICHAEL COOGAN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****04

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

MICHAEL

Last Name

COOGAN

Business Name

TIMOTHY MICHAEL COOGAN

Original Issue Date

03/12/2003

Effective Date

01/27/2014

Expiration Date

03/01/2016

City

CARBONDALE

State

Zip

62901

County

JACKSON

Ever Disciplined

LastModifiedDate

08/27/2018