CARLA DENISE SAMUEL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036124333

License Status

ACTIVE

Business

Title

First Name

CARLA

Middle

DENISE

Last Name

SAMUEL

Business Name

CARLA DENISE SAMUEL MD

Original Issue Date

09/04/2009

Effective Date

05/05/2023

Expiration Date

07/31/2026

City

MAHOMET

State

Zip

61853

County

CHAMPAIGN

Ever Disciplined

LastModifiedDate

05/05/2023