SAMUEL DAVID ROSENTHAL MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

CANCELLED

Business

First Name

SAMUEL

Middle

DAVID

Last Name

ROSENTHAL

Suffix

Business Name

SAMUEL DAVID ROSENTHAL MD

Original Issue Date

02/06/2003

Effective Date

02/06/2003

Expiration Date

07/31/2008

City

JACKSONVILLE

State

Zip

62650

County

MORGAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008