SAMUEL SANGBUM KOO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****04

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

SANGBUM

Last Name

KOO

Business Name

SAMUEL SANGBUM KOO

Original Issue Date

06/20/2008

Effective Date

06/20/2008

Expiration Date

07/31/2011

City

CHICAGO

State

Zip

60611

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011