SAMUEL ISAAC WOODARD DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065132

License Status

CANCELLED

Business

Title

First Name

SAMUEL

Middle

ISAAC

Last Name

WOODARD

Business Name

SAMUEL ISAAC WOODARD DO

Original Issue Date

07/01/2014

Effective Date

07/01/2014

Expiration Date

06/30/2017

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/10/2014