IVOR SAMUEL DOUGLAS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

IVOR SAMUEL

Last Name

DOUGLAS

Suffix

Business Name

IVOR SAMUEL DOUGLAS MD

Original Issue Date

09/08/1997

Effective Date

09/08/1997

Expiration Date

07/31/1999

City

CHICAGO

State

Zip

60637

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006