JAC ALAN COOPER MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125061379

License Status

EXPIRED

Business

First Name

JAC

Middle

ALAN

Last Name

COOPER

Suffix

Business Name

JAC ALAN COOPER MD

Original Issue Date

06/26/2015

Effective Date

06/26/2015

Expiration Date

06/25/2017

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/19/2017