SAMUEL D ALLEN Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125036128

License Status

EXPIRED

Business

First Name

SAMUEL

Middle

Last Name

ALLEN

Business Name

SAMUEL D ALLEN

Original Issue Date

05/16/1997

Effective Date

05/16/1997

Expiration Date

06/30/2000

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

09/22/2006