MARION MICHAEL IVANS JR Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****85

License Status

CANCELLED

Business

First Name

MARION MICHAEL

Last Name

IVANS JR

Business Name

MARION MICHAEL IVANS JR

Original Issue Date

01/01/1998

Expiration Date

09/30/2006

City

CHICAGO

State

Zip

60646

County

COOK

Controlled Substance Schedule

II III

Ever Disciplined

LastModifiedDate

07/24/2006