SAMUEL IRAN VAZQUEZ MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****49

License Status

ACTIVE

Business

Title

First Name

SAMUEL

Middle

IRAN

Last Name

VAZQUEZ

Business Name

SAMUEL IRAN VAZQUEZ MD

Original Issue Date

09/28/2023

Effective Date

09/28/2023

Expiration Date

07/31/2026

City

GALESBURG

State

Zip

61401

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/28/2023