SAM O SUE MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

NOT RENEWED

Business

First Name

SAM O

Last Name

SUE

Suffix

Business Name

SAM O SUE MD

Original Issue Date

04/29/1993

Effective Date

04/29/1993

Expiration Date

07/31/1996

City

SKOKIE

State

Zip

60077

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006