MELISSA DAWN KOOPMANN Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002310

License Status

NOT RENEWED

Business

First Name

MELISSA

Middle

DAWN

Last Name

KOOPMANN

Business Name

MELISSA DAWN KOOPMANN

Original Issue Date

09/01/2004

Effective Date

12/30/2019

Expiration Date

03/01/2022

City

CHICAGO

State

Zip

60616

County

COOK

Ever Disciplined

LastModifiedDate

07/27/2022