RUSSELL J IVANHOE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

NOT RENEWED

Business

First Name

RUSSELL J

Last Name

IVANHOE

Suffix

Business Name

RUSSELL J IVANHOE MD

Original Issue Date

10/24/1983

Effective Date

10/24/1983

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60615

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006