License holder summary

TIMOTHY BRYAN HEACKOCK is a Board Of Medicine licensed to practice in Idaho. The address on file for TIMOTHY BRYAN HEACKOCK is 3985 WINDY AVE NE ALBANY OR 97322. This licensed professional license is not current. The license was granted 01/15/2004 and expired on 06/30/2006.

Idaho

Division of Occupational and Professional Licenses

TIMOTHY BRYAN HEACKOCK
Board Of Medicine
License number
PGT-011
Date granted
01/15/2004
Date expires
06/30/2006
Class
Board Of Medicine
Status
Canceled
Address
3985 WINDY AVE NE ALBANY OR 97322
idaholicensing.com
ID 48329338
LAST UPDATED 2026-04-22 16:35:06 UTC

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