SAMARA GREEN CRUDUP MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125049665

License Status

EXPIRED

Business

First Name

SAMARA

Middle

GREEN

Last Name

CRUDUP

Suffix

Business Name

SAMARA GREEN CRUDUP MD

Original Issue Date

08/22/2008

Effective Date

08/22/2008

Expiration Date

10/21/2009

City

CHICAGO

State

Zip

60608

County

COOK

Specialty/Qualifier

Physical Medicine & Rehabilitation

Ever Disciplined

LastModifiedDate

12/23/2009