KENYN LAWRENCE KOOP MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000933

License Status

EXPIRED

Business

Title

First Name

KENYN

Middle

LAWRENCE

Last Name

KOOP

Business Name

KENYN LAWRENCE KOOP MD

Original Issue Date

02/09/2021

Effective Date

02/09/2021

Expiration Date

08/08/2021

City

ROCKFORD

State

Zip

61114

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022