AYODALE SAMUELLA JOHNSON Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125044498

License Status

EXPIRED

Business

First Name

AYODALE

Middle

SAMUELLA

Last Name

JOHNSON

Business Name

AYODALE SAMUELLA JOHNSON

Original Issue Date

06/20/2002

Effective Date

06/20/2002

Expiration Date

06/19/2003

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

09/22/2006