SAMUEL PORIZA AU MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****95

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

PORIZA

Last Name

Suffix

Business Name

SAMUEL PORIZA AU MD

Original Issue Date

01/19/2007

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

ALTON

State

Zip

62002

County

MADISON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020