MENA SAMWEL ISNASSUOS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125067861

License Status

CANCELLED

Business

Title

First Name

MENA

Middle

SAMWEL

Last Name

ISNASSUOS

Business Name

MENA SAMWEL ISNASSUOS MD

Original Issue Date

07/01/2015

Effective Date

07/01/2015

Expiration Date

06/30/2018

City

CHICAGO

State

Zip

60649

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

06/19/2015