STEPHEN A BOPPART Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****28

License Status

CANCELLED

Business

First Name

STEPHEN

Middle

Last Name

BOPPART

Business Name

STEPHEN A BOPPART

Original Issue Date

05/31/2005

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011