STEPHANIE DANIELLE IVINS MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****64

License Status

ACTIVE

Business

Title

First Name

STEPHANIE

Middle

DANIELLE

Last Name

IVINS

Business Name

STEPHANIE DANIELLE IVINS MD

Original Issue Date

08/13/2024

Effective Date

08/13/2024

Expiration Date

07/31/2026

City

RIVERWOODS

State

Zip

60015

County

LAKE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

08/13/2024