SAMUEL JACKSON YATES MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076190

License Status

EXPIRED

Business

Title

First Name

SAMUEL

Middle

JACKSON

Last Name

YATES

Business Name

SAMUEL JACKSON YATES MD

Original Issue Date

06/24/2020

Effective Date

06/24/2020

Expiration Date

06/23/2023

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/06/2024