SAMYUKTA KOPPULA Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036078244

License Status

ACTIVE

Business

First Name

SAMYUKTA

Last Name

KOPPULA

Business Name

SAMYUKTA KOPPULA

Original Issue Date

12/07/1988

Effective Date

06/30/2023

Expiration Date

07/31/2026

City

WILLOWBROOK

State

Zip

60527

Ever Disciplined

LastModifiedDate

06/30/2023