IVAN R LOPEZ - Medical Doctor License in Illinois | # 125042012

IVAN R LOPEZ

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125042012

License Status

EXPIRED

Business

N

First Name

IVAN

Middle

R

Last Name

LOPEZ

Business Name

IVAN R LOPEZ

Original Issue Date

07/01/2000

Effective Date

07/01/2000

Expiration Date

06/30/2003

State

IL

Specialty/Qualifier

Family Medicine

Ever Disciplined

N

LastModifiedDate

09/22/2006