SAMUEL PHILLIP SHATTAN MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****70

License Status

CANCELLED

Business

First Name

SAMUEL PHILLIP

Last Name

SHATTAN

Suffix

Business Name

SAMUEL PHILLIP SHATTAN MD

Original Issue Date

01/01/1997

Expiration Date

07/31/2008

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008