SAMUEL FAHMY BARAK BOTROS MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****40

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

FAHMY BARAK

Last Name

BOTROS

Suffix

Business Name

SAMUEL FAHMY BARAK BOTROS MD

Original Issue Date

07/24/2007

Effective Date

07/27/2020

Expiration Date

07/31/2023

City

BLOOMINGDALE

State

Zip

60108

County

DUPAGE

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/30/2023