MARK SAMUEL DIKOPF MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125063362

License Status

CANCELLED

Business

Title

First Name

MARK

Middle

SAMUEL

Last Name

DIKOPF

Business Name

MARK SAMUEL DIKOPF MD

Original Issue Date

07/01/2016

Effective Date

07/01/2016

Expiration Date

06/30/2017

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

02/18/2016