DENNIS R SAMUELSON MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045578

License Status

NOT RENEWED

Business

First Name

DENNIS R

Last Name

SAMUELSON

Suffix

Business Name

DENNIS R SAMUELSON MD

Original Issue Date

03/27/1972

Effective Date

07/01/2014

Expiration Date

07/31/2017

City

MACOMB

State

Zip

61455

County

MCDONOUGH

Ever Disciplined

LastModifiedDate

11/01/2017