KIMBALL IVAN MAULL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

KIMBALL IVAN

Last Name

MAULL

Suffix

Business Name

KIMBALL IVAN MAULL MD

Original Issue Date

10/07/1994

Effective Date

10/07/1994

Expiration Date

07/31/1999

City

MAYWOOD

State

Zip

60153

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006