CARMEN E KOUBICEK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****68

License Status

NOT RENEWED

Business

First Name

CARMEN E

Last Name

KOUBICEK

Suffix

Business Name

CARMEN E KOUBICEK MD

Original Issue Date

08/18/1993

Effective Date

08/18/1993

Expiration Date

07/31/1999

City

DANVILLE

State

Zip

61832

County

VERMILION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006