SAMUEL H IDARRAGA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125024170

License Status

EXPIRED

Business

First Name

SAMUEL

Middle

Last Name

IDARRAGA

Business Name

SAMUEL H IDARRAGA

Original Issue Date

06/21/1989

Effective Date

06/21/1989

Expiration Date

06/25/1992

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006