SAMUEL D SOUTH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036145766

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

Last Name

SOUTH

Suffix

Business Name

SAMUEL D SOUTH MD

Original Issue Date

04/18/2018

Effective Date

04/18/2018

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60622

County

COOK

Ever Disciplined

LastModifiedDate

01/14/2021