SHANTHARAJ SAMUEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041957

License Status

NOT RENEWED

Business

First Name

SHANTHARAJ

Last Name

SAMUEL

Suffix

Business Name

SHANTHARAJ SAMUEL MD

Original Issue Date

07/18/1968

Effective Date

07/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60634

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021