AMMAR Y DIVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

Title

First Name

AMMAR

Middle

Last Name

DIVAN

Business Name

AMMAR Y DIVAN MD

Original Issue Date

05/21/2009

Effective Date

05/21/2009

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020