SAM FATOOREHCHI MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125068516

License Status

CANCELLED

Business

Title

First Name

SAM

Last Name

FATOOREHCHI

Business Name

SAM FATOOREHCHI MD

Original Issue Date

06/26/2016

Effective Date

06/26/2016

Expiration Date

06/25/2019

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/18/2016