IVAN A BOLIVAR MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033412

License Status

EXPIRED

Business

First Name

IVAN

Middle

Last Name

BOLIVAR

Suffix

Business Name

IVAN A BOLIVAR MD

Original Issue Date

06/15/1995

Effective Date

06/15/1995

Expiration Date

06/30/1999

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006