SAMANTHA MICHELLE DAVIDSON Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****03

License Status

ACTIVE

Business

First Name

SAMANTHA

Middle

MICHELLE

Last Name

DAVIDSON

Business Name

SAMANTHA MICHELLE DAVIDSON

Original Issue Date

09/16/2025

Effective Date

09/16/2025

Expiration Date

07/31/2026

City

PEORIA

State

Zip

61637

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/16/2025