SAMUEL T BAZ MD 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

First Name

SAMUEL T

Last Name

BAZ

Suffix

Business Name

SAMUEL T BAZ MD

Original Issue Date

01/01/1997

Effective Date

05/06/2011

Expiration Date

07/31/2014

City

WENONA

State

Zip

61377

County

MARSHALL

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/11/2017