SAMUEL DEAN FOX MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****24

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

DEAN

Last Name

FOX

Business Name

SAMUEL DEAN FOX MD

Original Issue Date

08/10/2011

Effective Date

05/17/2023

Expiration Date

07/31/2026

City

GALESBURG

State

Zip

61401

County

KNOX

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/17/2023