DAVID L SAMUEL MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060969

License Status

NOT RENEWED

Business

First Name

DAVID

Middle

Last Name

SAMUEL

Suffix

Business Name

DAVID L SAMUEL MD

Original Issue Date

09/11/1980

Effective Date

09/11/1980

Expiration Date

07/31/1996

City

MANDEVILLE

State

Zip

70471

Ever Disciplined

LastModifiedDate

07/09/2007

Case Number

1994005972

Action

Suspension

Discipline Start Date

04/05/1995

Discipline End Date

07/04/1995

Discipline Reason

Disciplined in Wisconsin.