ZITA SUSAN SAMUEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112048

License Status

NOT RENEWED

Business

First Name

ZITA

Middle

SUSAN

Last Name

SAMUEL

Suffix

Business Name

ZITA SUSAN SAMUEL MD

Original Issue Date

08/06/2004

Effective Date

07/31/2006

Expiration Date

07/31/2008

City

OAK PARK

State

Zip

60301

County

COOK

Ever Disciplined

LastModifiedDate

11/06/2008