SAMANTHA FAN LU MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****83

License Status

ACTIVE

Business

Title

First Name

SAMANTHA

Middle

FAN

Last Name

Business Name

SAMANTHA FAN LU MD

Original Issue Date

06/28/2021

Effective Date

04/20/2023

Expiration Date

07/31/2026

City

CHICAGO

State

Zip

60611

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/20/2023