SAMUEL DALTON CAPOUCH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036164600

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

DALTON

Last Name

CAPOUCH

Business Name

SAMUEL DALTON CAPOUCH MD

Original Issue Date

05/03/2023

Effective Date

05/03/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

01/06/2026