ROBERTA L KOEPPEN MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125077975

License Status

ACTIVE

Business

Title

First Name

ROBERTA

Middle

Last Name

KOEPPEN

Business Name

ROBERTA L KOEPPEN MD

Original Issue Date

06/26/2024

Effective Date

06/26/2024

Expiration Date

06/25/2026

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Urology

Ever Disciplined

LastModifiedDate

03/20/2024