DANIEL THEODORE STOPKA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****97

License Status

NOT RENEWED

Business

Title

First Name

DANIEL

Middle

THEODORE

Last Name

STOPKA

Business Name

DANIEL THEODORE STOPKA MD

Original Issue Date

09/03/2014

Effective Date

09/03/2014

Expiration Date

07/31/2017

City

PEORIA

State

Zip

61602

County

PEORIA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020