SAMUEL PATRICK GASTINEAU Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075069

License Status

EXPIRED

Business

First Name

SAMUEL

Middle

PATRICK

Last Name

GASTINEAU

Business Name

SAMUEL PATRICK GASTINEAU

Original Issue Date

06/24/2019

Effective Date

06/24/2019

Expiration Date

06/23/2022

City

CHICAGO

State

Zip

60631

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

10/11/2022