IVAN A GORBACHEV MD - Medical Doctor License in Illinois | # 125040215

IVAN A GORBACHEV MD

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125040215

License Status

CANCELLED

Business

N

First Name

IVAN

Middle

A

Last Name

GORBACHEV

Suffix

MD

Business Name

IVAN A GORBACHEV MD

Original Issue Date

07/01/1999

Effective Date

07/01/1999

Expiration Date

06/30/2002

State

IL

Specialty/Qualifier

Internal Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006