License Directory

Ivan South Fucilla Md

Expired

Illinois license 036035854

License

Licensed by
Illinois Department of Financial and Professional Regulation
License number
036035854
Status
Expired (Not Renewed)
First issued
June 9, 1959
Expired
July 31, 1984
License holder
Ivan South Fucilla Md
Entity type
Individual

Classifications

More from the license record

Current term began
06/09/1959

Contact

Los Altos, CA 94022
California County