RUSSELL J IVANHOE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036067414

License Status

NOT RENEWED

Business

First Name

RUSSELL J

Last Name

IVANHOE

Suffix

Business Name

RUSSELL J IVANHOE MD

Original Issue Date

08/31/1983

Effective Date

08/31/1983

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006