SUSAN SAM MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****34

License Status

ACTIVE

Business

First Name

SUSAN

Last Name

SAM

Suffix

Business Name

SUSAN SAM MD

Original Issue Date

03/25/1998

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60614

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023