SAMUEL D SOUTH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064125

License Status

EXPIRED

Business

First Name

SAMUEL

Middle

Last Name

SOUTH

Suffix

Business Name

SAMUEL D SOUTH MD

Original Issue Date

06/26/2013

Effective Date

06/26/2013

Expiration Date

06/25/2016

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

General Surgery

Ever Disciplined

LastModifiedDate

08/16/2016