SAMUEL D REGISTER III MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125016167

License Status

EXPIRED

Business

First Name

SAMUEL

Middle

Last Name

Suffix

III MD

Business Name

SAMUEL D REGISTER III MD

Original Issue Date

07/08/1983

Effective Date

07/08/1983

Expiration Date

08/01/1985

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006