SAMUEL BAZ MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036105346

License Status

NOT RENEWED

Business

First Name

SAMUEL

Last Name

BAZ

Suffix

Business Name

SAMUEL BAZ MD

Original Issue Date

08/01/2001

Effective Date

08/01/2001

Expiration Date

07/31/2005

City

WENONA

State

Zip

61377

County

LA SALLE

Ever Disciplined

LastModifiedDate

10/09/2006