SAMUEL BOGGUST ZOUCHA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125071276

License Status

EXPIRED

Business

Title

First Name

SAMUEL

Middle

BOGGUST

Last Name

ZOUCHA

Business Name

SAMUEL BOGGUST ZOUCHA MD

Original Issue Date

07/01/2017

Effective Date

07/01/2017

Expiration Date

06/30/2020

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

11/19/2020