KENNETH HENRY COPPERWHEAT DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125069189

License Status

CANCELLED

Business

Title

First Name

KENNETH

Middle

HENRY

Last Name

COPPERWHEAT

Business Name

KENNETH HENRY COPPERWHEAT DO

Original Issue Date

06/25/2016

Effective Date

06/25/2016

Expiration Date

06/24/2019

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

05/11/2016