SAM SADEGH MALAKOUTI MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****75

License Status

NOT RENEWED

Business

Title

First Name

SAM

Middle

SADEGH

Last Name

MALAKOUTI

Business Name

SAM SADEGH MALAKOUTI MD

Original Issue Date

11/28/2012

Effective Date

10/11/2017

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60640

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021