SIREESHA KOPPULA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050145

License Status

EXPIRED

Business

First Name

SIREESHA

Last Name

KOPPULA

Suffix

Business Name

SIREESHA KOPPULA MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2008

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/31/2008