JORDAN SETH SAMUELS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057168

License Status

CANCELLED

Business

Title

First Name

JORDAN

Middle

SETH

Last Name

SAMUELS

Business Name

JORDAN SETH SAMUELS MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2013

City

LAKE BARRINGTON

State

Zip

60010

County

COOK

Specialty/Qualifier

Neurology

Ever Disciplined

LastModifiedDate

05/03/2012