SUSAN C SAMUEL MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049620

License Status

EXPIRED

Business

First Name

SUSAN

Middle

Last Name

SAMUEL

Suffix

Business Name

SUSAN C SAMUEL MD

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

07/31/2008