SAMANTHA GABRIELE DAUM DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074546

License Status

EXPIRED

Business

Title

First Name

SAMANTHA

Middle

GABRIELE

Last Name

DAUM

Business Name

SAMANTHA GABRIELE DAUM DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022