EUGEN IVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****23

License Status

NOT RENEWED

Business

First Name

EUGEN

Last Name

IVAN

Suffix

Business Name

EUGEN IVAN MD

Original Issue Date

12/08/2004

Effective Date

12/08/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2011