HAYWOOD M INGRAM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****72

License Status

NOT RENEWED

Business

First Name

HAYWOOD M

Last Name

INGRAM

Suffix

Business Name

HAYWOOD M INGRAM MD

Original Issue Date

06/25/1984

Effective Date

06/25/1984

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60611

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006