SAMUEL C DUDLEY JR MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****16

License Status

NOT RENEWED

Business

First Name

SAMUEL

Middle

Last Name

DUDLEY

Suffix

JR MD

Business Name

SAMUEL C DUDLEY JR MD

Original Issue Date

08/03/2007

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

MINNEAPOLIS

State

Zip

55455

County

RHODE ISLAND

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021