BETH HOLLY SAMUELSOHN DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125034527

License Status

EXPIRED

Business

First Name

BETH

Middle

HOLLY

Last Name

SAMUELSOHN

Suffix

Business Name

BETH HOLLY SAMUELSOHN DO

Original Issue Date

05/20/1996

Effective Date

05/20/1996

Expiration Date

05/07/2000

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006