ILIA ITIN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036109662

License Status

NOT RENEWED

Business

First Name

ILIA

Last Name

ITIN

Suffix

Business Name

ILIA ITIN MD

Original Issue Date

07/08/2003

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

UNIVERSITY HEIGHTS

State

Zip

44118

County

OHIO

Ever Disciplined

LastModifiedDate

11/06/2008