ALEXANDER SKAVYSH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****42

License Status

NOT RENEWED

Business

Title

First Name

ALEXANDER

Last Name

SKAVYSH

Business Name

ALEXANDER SKAVYSH MD

Original Issue Date

05/04/2012

Effective Date

05/04/2012

Expiration Date

07/31/2014

City

BLOOMINGTON

State

Zip

47401

County

INDIANA

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014