SAMANTHA B CONRAD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034317

License Status

EXPIRED

Business

Title

First Name

SAMANTHA

Middle

Last Name

CONRAD

Business Name

SAMANTHA B CONRAD MD

Original Issue Date

05/11/1996

Effective Date

05/11/1996

Expiration Date

06/17/2000

City

CHICAGO

State

Zip

60657

Specialty/Qualifier

Dermatology

Ever Disciplined

LastModifiedDate

09/22/2006