PRABHAT KOPPERA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049342

License Status

EXPIRED

Business

First Name

PRABHAT

Last Name

KOPPERA

Suffix

Business Name

PRABHAT KOPPERA MD

Original Issue Date

06/22/2005

Effective Date

06/22/2005

Expiration Date

06/21/2006

City

CHICAGO

State

Zip

60657

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006