DIANE KOPEIKA GOTTSCHALK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****56

License Status

NOT RENEWED

Business

First Name

DIANE

Middle

KOPEIKA

Last Name

GOTTSCHALK

Suffix

Business Name

DIANE KOPEIKA GOTTSCHALK MD

Original Issue Date

09/27/1989

Effective Date

09/27/1989

Expiration Date

07/31/1996

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006