ALEXANDER YAKOV FACTOUROVICH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045102

License Status

EXPIRED

Business

First Name

ALEXANDER

Middle

YAKOV

Last Name

FACTOUROVICH

Suffix

Business Name

ALEXANDER YAKOV FACTOUROVICH MD

Original Issue Date

07/01/2002

Effective Date

07/01/2002

Expiration Date

06/30/2005

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006