THEODORE SAMUEL EISENMAN MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036039879

License Status

NOT RENEWED

Business

First Name

THEODORE SAMUEL

Last Name

EISENMAN

Suffix

Business Name

THEODORE SAMUEL EISENMAN MD

Original Issue Date

08/20/1965

Effective Date

04/28/2014

Expiration Date

07/31/2017

City

WILMETTE

State

Zip

60091

County

COOK

Ever Disciplined

LastModifiedDate

11/01/2017