SAMANTHA LEE STARK MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068358

License Status

EXPIRED

Business

Title

First Name

SAMANTHA

Middle

LEE

Last Name

STARK

Business Name

SAMANTHA LEE STARK MD

Original Issue Date

06/23/2019

Effective Date

06/23/2019

Expiration Date

06/22/2020

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

11/19/2020