ELDON MCKENZIE SAMUEL MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

ACTIVE

Business

First Name

ELDON

Middle

MCKENZIE

Last Name

SAMUEL

Suffix

Business Name

ELDON MCKENZIE SAMUEL MD

Original Issue Date

02/20/2004

Effective Date

07/12/2023

Expiration Date

07/31/2026

City

KEWANEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/12/2023