AMANDA NICOLE COOPER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057343

License Status

CANCELLED

Business

Title

First Name

AMANDA

Middle

NICOLE

Last Name

COOPER

Business Name

AMANDA NICOLE COOPER MD

Original Issue Date

07/01/2010

Effective Date

07/01/2010

Expiration Date

06/30/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

03/24/2010