SAMIR D UNDEVIA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****17

License Status

ACTIVE

Business

Title

First Name

SAMIR

Middle

Last Name

UNDEVIA

Business Name

SAMIR D UNDEVIA MD

Original Issue Date

12/08/2014

Effective Date

05/01/2023

Expiration Date

07/31/2026

City

PLAINFIELD

State

Zip

60585

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/01/2023