GLENSON SAMUEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****65

License Status

NOT RENEWED

Business

First Name

GLENSON

Last Name

SAMUEL

Suffix

Business Name

GLENSON SAMUEL MD

Original Issue Date

04/13/2010

Effective Date

04/13/2010

Expiration Date

07/31/2011

City

SPRINGFIELD

State

Zip

62701

County

SANGAMON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011