SAMYUKTA KOPPULA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125020939

License Status

EXPIRED

Business

First Name

SAMYUKTA

Last Name

KOPPULA

Business Name

SAMYUKTA KOPPULA

Original Issue Date

05/19/1987

Effective Date

05/19/1987

Expiration Date

06/23/1990

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006