HEATHER LYNN SAMUDOVSKY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085007904

License Status

ACTIVE

Business

First Name

HEATHER

Middle

LYNN

Last Name

SAMUDOVSKY

Business Name

HEATHER LYNN SAMUDOVSKY

Original Issue Date

08/29/2020

Effective Date

02/24/2026

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62712

County

SANGAMON

Ever Disciplined

LastModifiedDate

02/24/2026