IVAN A GORBACHEV MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040215

License Status

CANCELLED

Business

First Name

IVAN

Middle

Last Name

GORBACHEV

Suffix

Business Name

IVAN A GORBACHEV MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006