SAMUEL S PARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****05

License Status

ACTIVE

Business

First Name

SAMUEL

Middle

Last Name

PARK

Suffix

Business Name

SAMUEL S PARK MD

Original Issue Date

06/24/2023

Effective Date

06/24/2023

Expiration Date

07/31/2026

City

JOLIET

State

Zip

60431

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/24/2023