ALEXANDER ANATOLYEVICH IVANOV MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057135

License Status

CANCELLED

Business

Title

First Name

ALEXANDER

Middle

ANATOLYEVICH

Last Name

IVANOV

Business Name

ALEXANDER ANATOLYEVICH IVANOV MD

Original Issue Date

07/16/2009

Effective Date

07/16/2009

Expiration Date

07/15/2012

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurological Surgery

Ever Disciplined

LastModifiedDate

04/15/2010