OMAR ABDUS SAMAD ALI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****38

License Status

NOT RENEWED

Business

First Name

OMAR

Middle

ABDUS SAMAD

Last Name

ALI

Suffix

Business Name

OMAR ABDUS SAMAD ALI MD

Original Issue Date

03/18/2004

Effective Date

01/11/2012

Expiration Date

07/31/2014

City

EVANSTON

State

Zip

60201

County

COOK

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/17/2014