GLENSON SAMUEL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125053115

License Status

CANCELLED

Business

First Name

GLENSON

Last Name

SAMUEL

Suffix

Business Name

GLENSON SAMUEL MD

Original Issue Date

06/26/2007

Effective Date

06/26/2007

Expiration Date

06/25/2010

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

03/25/2011