SAM AMIR MIKHAIL DO Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

Title

First Name

SAM

Middle

AMIR

Last Name

MIKHAIL

Business Name

SAM AMIR MIKHAIL DO

Original Issue Date

12/06/2013

Effective Date

05/09/2014

Expiration Date

07/31/2017

City

CHAMPAIGN

State

Zip

61822

County

CHAMPAIGN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/01/2017