ANDRE DEDRICK IVY MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036132427

License Status

ACTIVE

Business

Title

First Name

ANDRE

Middle

DEDRICK

Last Name

IVY

Business Name

ANDRE DEDRICK IVY MD

Original Issue Date

04/15/2013

Effective Date

07/07/2023

Expiration Date

07/31/2026

City

LOMBARD

State

Zip

60148

County

DUPAGE

Ever Disciplined

LastModifiedDate

07/07/2023