CRYSTAL CHARLYNN COOPER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****61

License Status

NOT RENEWED

Business

Title

First Name

CRYSTAL

Middle

CHARLYNN

Last Name

COOPER

Business Name

CRYSTAL CHARLYNN COOPER MD

Original Issue Date

07/20/2020

Effective Date

07/20/2020

Expiration Date

07/31/2023

City

GROSSE POINTE

State

Zip

48236

County

WAYNE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023