SAMUEL ETHAN KLEIN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125070930

License Status

CANCELLED

Business

Title

First Name

SAMUEL

Middle

ETHAN

Last Name

KLEIN

Business Name

SAMUEL ETHAN KLEIN MD

Original Issue Date

07/01/2020

Effective Date

07/01/2020

Expiration Date

06/30/2021

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Emergency Medicine

Ever Disciplined

LastModifiedDate

04/21/2020