BRIAN L SAMUELS MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

CANCELLED

Business

First Name

BRIAN L

Last Name

SAMUELS

Suffix

Business Name

BRIAN L SAMUELS MD

Original Issue Date

03/20/1985

Effective Date

03/20/1985

Expiration Date

07/31/2005

City

PARK RIDGE

State

Zip

60068

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/09/2006