DAVID L SAMUEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****46

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

SAMUEL

Suffix

Business Name

DAVID L SAMUEL MD

Original Issue Date

09/19/1991

Effective Date

09/19/1991

Expiration Date

07/31/1996

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006