KEITH ALAN LOPATKA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040838

License Status

EXPIRED

Business

First Name

KEITH

Middle

ALAN

Last Name

LOPATKA

Suffix

Business Name

KEITH ALAN LOPATKA MD

Original Issue Date

06/24/2000

Effective Date

06/24/2000

Expiration Date

06/30/2005

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

09/22/2006