MALIE KAY KOPPLIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****71

License Status

CANCELLED

Business

First Name

MALIE

Middle

KAY

Last Name

KOPPLIN

Suffix

Business Name

MALIE KAY KOPPLIN MD

Original Issue Date

05/14/1999

Effective Date

05/14/1999

Expiration Date

07/31/2002

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006