ALEC SAMUEL SMALL DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

ACTIVE

Business

Title

First Name

ALEC

Middle

SAMUEL

Last Name

SMALL

Business Name

ALEC SAMUEL SMALL DO

Original Issue Date

09/11/2023

Effective Date

09/11/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60612

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/11/2023