LARRY DAVID SAMUELS Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****94

License Status

NOT RENEWED

Business

First Name

LARRY DAVID

Last Name

SAMUELS

Business Name

LARRY DAVID SAMUELS

Original Issue Date

02/02/1984

Effective Date

02/02/1984

Expiration Date

07/31/1999

City

NEW WINDSOR

State

Zip

61465

County

MERCER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006