IVOR SAMUEL DOUGLAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036096643

License Status

NOT RENEWED

Business

First Name

IVOR SAMUEL

Last Name

DOUGLAS

Suffix

Business Name

IVOR SAMUEL DOUGLAS MD

Original Issue Date

09/05/1997

Effective Date

09/05/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60615

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006