SAMIR S MISSAK MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****96

License Status

NOT RENEWED

Business

First Name

SAMIR S

Last Name

MISSAK

Suffix

Business Name

SAMIR S MISSAK MD

Original Issue Date

09/20/1985

Effective Date

09/20/1985

Expiration Date

07/31/1990

City

CHICAGO

State

Zip

60614

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006