MATTHEW I SAMUELSON MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****06

License Status

ACTIVE

Business

First Name

MATTHEW I

Last Name

SAMUELSON

Suffix

Business Name

MATTHEW I SAMUELSON MD

Original Issue Date

01/30/1996

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

PRAIRIE GROVE

State

Zip

60012

County

MCHENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023