WALTER IHOR MELNYCZENKO MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****22

License Status

NOT RENEWED

Business

First Name

WALTER

Middle

IHOR

Last Name

MELNYCZENKO

Suffix

Business Name

WALTER IHOR MELNYCZENKO MD

Original Issue Date

11/06/1985

Effective Date

11/06/1985

Expiration Date

07/31/1993

City

BELVIDERE

State

Zip

61008

County

BOONE

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006