IVAN EDUARDO LIZARAZO MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053776

License Status

CANCELLED

Business

First Name

IVAN

Middle

EDUARDO

Last Name

LIZARAZO

Suffix

Business Name

IVAN EDUARDO LIZARAZO MD

Original Issue Date

07/01/2007

Effective Date

07/01/2007

Expiration Date

06/30/2010

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/15/2007