GREGORY LAWRENCE COOPER DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****49

License Status

CANCELLED

Business

First Name

GREGORY

Middle

LAWRENCE

Last Name

COOPER

Suffix

DPM

Business Name

GREGORY LAWRENCE COOPER DPM

Original Issue Date

11/07/2001

Effective Date

11/07/2001

Expiration Date

01/31/2003

City

CHAMPAIGN

State

Zip

61820

County

CHAMPAIGN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/25/2006