SAMUEL TRAVERSO DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074102

License Status

CANCELLED

Business

Title

First Name

SAMUEL

Last Name

TRAVERSO

Business Name

SAMUEL TRAVERSO DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

LA GRANGE HIGHLANDS

State

Zip

60525

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

05/17/2019