SUSAN SAM MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125033139

License Status

EXPIRED

Business

First Name

SUSAN

Last Name

SAM

Suffix

Business Name

SUSAN SAM MD

Original Issue Date

06/07/1995

Effective Date

06/07/1995

Expiration Date

06/19/1998

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006