SAMUEL SOLOMON LAKE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****18

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

SOLOMON

Last Name

LAKE

Business Name

SAMUEL SOLOMON LAKE MD

Original Issue Date

04/30/2022

Effective Date

05/02/2023

Expiration Date

07/31/2026

City

BARTLETT

State

Zip

60103

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/02/2023