MARK ALLEN KOPPEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045645

License Status

CANCELLED

Business

First Name

MARK

Middle

ALLEN

Last Name

KOPPEL

Suffix

Business Name

MARK ALLEN KOPPEL MD

Original Issue Date

04/24/2003

Effective Date

04/24/2003

Expiration Date

06/30/2006

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

09/22/2006