SAMANTHA MICHELLE ENSTAD MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125065295

License Status

EXPIRED

Business

Title

First Name

SAMANTHA

Middle

MICHELLE

Last Name

ENSTAD

Business Name

SAMANTHA MICHELLE ENSTAD MD

Original Issue Date

06/23/2014

Effective Date

06/23/2014

Expiration Date

06/22/2017

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

09/19/2017