SAMANTHA ALYSSA LOZA MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074318

License Status

EXPIRED

Business

Title

First Name

SAMANTHA

Middle

ALYSSA

Last Name

LOZA

Business Name

SAMANTHA ALYSSA LOZA MD

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Pediatrics

Ever Disciplined

LastModifiedDate

10/11/2022