EUGEN IVAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112669

License Status

NOT RENEWED

Business

First Name

EUGEN

Last Name

IVAN

Suffix

Business Name

EUGEN IVAN MD

Original Issue Date

11/17/2004

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

SALT LAKE CITY

State

Zip

84121

County

UTAH

Ever Disciplined

LastModifiedDate

11/14/2011