SAMANTHA JANE DIAL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****41

License Status

ACTIVE

Business

Title

First Name

SAMANTHA

Middle

JANE

Last Name

DIAL

Business Name

SAMANTHA JANE DIAL MD

Original Issue Date

03/25/2016

Effective Date

07/21/2023

Expiration Date

07/31/2026

City

SPRINGFIELD

State

Zip

62702

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/21/2023