PARAG SURESH SAMPAT MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****92

License Status

CANCELLED

Business

First Name

PARAG

Middle

SURESH

Last Name

SAMPAT

Suffix

Business Name

PARAG SURESH SAMPAT MD

Original Issue Date

04/12/2004

Effective Date

04/12/2004

Expiration Date

07/31/2008

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008