SAMANTHA L DAVIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085004010

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

Last Name

DAVIS

Business Name

SAMANTHA L DAVIS

Original Issue Date

03/15/2011

Effective Date

03/03/2014

Expiration Date

03/01/2016

City

CHICAGO

State

Zip

60601

County

COOK

Ever Disciplined

LastModifiedDate

04/25/2016