DANA SPIVAK Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036106044

License Status

NOT RENEWED

Business

First Name

DANA

Last Name

SPIVAK

Business Name

DANA SPIVAK

Original Issue Date

12/28/2001

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

PLAINFIELD

State

Zip

60544

County

WILL

Ever Disciplined

LastModifiedDate

11/06/2008