KENNETH HENRY COPPERWHEAT DO - Medical Doctor License in Illinois | # 125069189

KENNETH HENRY COPPERWHEAT DO

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069189

License Status

CANCELLED

Business

N

Title

DO

First Name

KENNETH

Middle

HENRY

Last Name

COPPERWHEAT

Business Name

KENNETH HENRY COPPERWHEAT DO

Original Issue Date

06/25/2016

Effective Date

06/25/2016

Expiration Date

06/24/2019

State

IL

Specialty/Qualifier

General Surgery

Ever Disciplined

N

LastModifiedDate

05/11/2016