PENELOPE K TIPPY Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****58

License Status

NOT RENEWED

Business

First Name

PENELOPE K

Last Name

TIPPY

Business Name

PENELOPE K TIPPY

Original Issue Date

01/01/1997

Effective Date

06/26/2017

Expiration Date

09/30/2020

City

CARBONDALE

State

Zip

62901

County

JACKSON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021