| | Physician Last Name: | Canham |
| | Physician First Name: | Timothy |
| | Physician Middle Name: | P. |
| | Address: | Address redacted |
| | License Number: | 004006 |
| | License Type: | PA |
| | Year of Birth: |
1961
|
| | Effective Date: | 08/25/2020 |
| | Action Description for DOH Webpage: | This order modifies the original penalty and allows the physician assistant to surrender his license as a physician assistant and precludes him from performing medical services in New York State. |
| | Misconduct Description for DOH Webpage: | This order is a modification of the terms and conditions previously imposed under BPMC# 17-203 that went into effect July 27, 2017 and does not constitute a new disciplinary action. The physician assistant asserted he could not successfully defend against at least one of the charges of professional misconduct by having been disciplined by the State of Maine Board of Licensure in Medicine for having failed to notify a change in or registration of his supervising physician. |
| | License Limitations or Conditions for DOH Webpage: | |
| | Board Order: |
|
