Ohio
Board of Licensing
Anderson, Samuel-COPC
Medical Board - 41.Pa Supervision Agreement
License number
41.15375-SA
Date granted
09/12/2012
Date expires
01/31/2015
Class
Medical Board - 41.Pa Supervision Agreement
Status
Active (In Renewal)
Address
500 Thomas Lane #3G, Columbus, OH 43214
ohiolicensing.org
ID 29521512
LAST UPDATED 2026-05-26 10:53:45 UTC
LAST UPDATED 2026-05-26 10:53:45 UTC