The holder whose full name is SAMUELSON, MATTHEW IRA,come from Crystal Lake IL,hold the Physician license(NO.01054430A) which status is Expired Non-Renewable.
| Name | SAMUELSON, MATTHEW IRA |
|---|---|
| License Number | 01054430A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Crystal Lake |
| State | IL |