SAM AMIR MIKHAIL DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060712

License Status

CANCELLED

Business

Title

First Name

SAM

Middle

AMIR

Last Name

MIKHAIL

Business Name

SAM AMIR MIKHAIL DO

Original Issue Date

09/18/2011

Effective Date

09/18/2011

Expiration Date

09/17/2014

City

URBANA

State

Zip

61801

County

CHAMPAIGN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/20/2011