SAMUEL GRADY PUTNAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****32

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

GRADY

Last Name

PUTNAM

Business Name

SAMUEL GRADY PUTNAM MD

Original Issue Date

10/08/2024

Effective Date

10/08/2024

Expiration Date

07/31/2026

City

URBANA

State

Zip

61801

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/08/2024