ALEXIA SHEALYNNE COPENHAVER MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071323

License Status

CANCELLED

Business

Title

First Name

ALEXIA

Middle

SHEALYNNE

Last Name

COPENHAVER

Business Name

ALEXIA SHEALYNNE COPENHAVER MD

Original Issue Date

06/24/2017

Effective Date

06/24/2017

Expiration Date

06/23/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

05/24/2017