RONALD E SAM DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

First Name

RONALD E

Last Name

SAM

Suffix

Business Name

RONALD E SAM DO

Original Issue Date

12/30/1996

Effective Date

06/15/2023

Expiration Date

07/31/2026

City

OAK LAWN

State

Zip

60453

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/15/2023