SAMUEL ROBERT NUSSBAUM MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036097130

License Status

NOT RENEWED

Business

First Name

SAMUEL ROBERT

Last Name

NUSSBAUM

Suffix

Business Name

SAMUEL ROBERT NUSSBAUM MD

Original Issue Date

12/26/1997

Effective Date

07/26/2011

Expiration Date

07/31/2014

City

INDIANAPOLIS

State

Zip

46204

County

INDIANA

Ever Disciplined

LastModifiedDate

11/17/2014