MIRA B KUPISEK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036078086

License Status

NOT RENEWED

Business

First Name

MIRA B

Last Name

KUPISEK

Business Name

MIRA B KUPISEK

Original Issue Date

10/26/1988

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

PALM COAST

State

Zip

32164

County

FLORIDA

Ever Disciplined

LastModifiedDate

11/14/2011