SAMUEL S PARK MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****08

License Status

ACTIVE

Business

First Name

SAMUEL

Middle

Last Name

PARK

Suffix

Business Name

SAMUEL S PARK MD

Original Issue Date

04/04/2022

Effective Date

05/31/2023

Expiration Date

07/31/2026

City

OLYMPIA FIELDS

State

Zip

60461

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

Ever Disciplined

LastModifiedDate

05/31/2023