KASSANDRA COOPER TUCKER DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065930

License Status

CANCELLED

Business

Title

First Name

KASSANDRA

Middle

COOPER

Last Name

TUCKER

Business Name

KASSANDRA COOPER TUCKER DO

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

05/29/2014