OMAR ABDUS SAMAD ALI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036111040

License Status

NOT RENEWED

Business

First Name

OMAR

Middle

ABDUS SAMAD

Last Name

ALI

Suffix

Business Name

OMAR ABDUS SAMAD ALI MD

Original Issue Date

03/18/2004

Effective Date

05/03/2011

Expiration Date

07/31/2014

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

11/17/2014

Case Number

2012005177

Action

Fine

Discipline Start Date

01/30/2013

Discipline Reason

after provided several prescriptions to a co-worker without establishing medical records.