SAMUEL D D AGATA MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036077161

License Status

NOT RENEWED

Business

First Name

SAMUEL D

Last Name

D AGATA

Suffix

Business Name

SAMUEL D D AGATA MD

Original Issue Date

06/25/1988

Effective Date

06/25/1988

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60613

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006