SAMANTHA B CONRAD MD - Medical Doctor License in Illinois | # 125034317

SAMANTHA B CONRAD MD

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034317

License Status

EXPIRED

Business

N

Title

MD

First Name

SAMANTHA

Middle

B

Last Name

CONRAD

Business Name

SAMANTHA B CONRAD MD

Original Issue Date

05/11/1996

Effective Date

05/11/1996

Expiration Date

06/17/2000

State

IL

Specialty/Qualifier

Dermatology

Ever Disciplined

N

LastModifiedDate

09/22/2006