IVOR SAMUEL DOUGLAS MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033896

License Status

EXPIRED

Business

First Name

IVOR SAMUEL

Last Name

DOUGLAS

Suffix

Business Name

IVOR SAMUEL DOUGLAS MD

Original Issue Date

08/17/1995

Effective Date

08/17/1995

Expiration Date

08/15/1998

City

CHICAGO

State

Zip

60637

County

COOK

Ever Disciplined

LastModifiedDate

09/22/2006