AMANDA NICOLE COOPER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****11

License Status

NOT RENEWED

Business

Title

First Name

AMANDA

Middle

NICOLE

Last Name

COOPER

Business Name

AMANDA NICOLE COOPER MD

Original Issue Date

04/08/2013

Effective Date

04/08/2013

Expiration Date

07/31/2014

City

WHITEFISH BAY

State

Zip

53217

County

WISCONSIN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017