DANA SPIVAK Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125039457

License Status

EXPIRED

Business

First Name

DANA

Last Name

SPIVAK

Business Name

DANA SPIVAK

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

HINSDALE

State

Zip

60521

County

DUPAGE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006