SAMUEL LEE JOHNSON DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125083250

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

LEE

Last Name

JOHNSON

Business Name

SAMUEL LEE JOHNSON DO

Original Issue Date

07/01/2024

Effective Date

07/01/2024

Expiration Date

06/30/2027

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Anesthesiology

Ever Disciplined

LastModifiedDate

04/23/2024