SAMANTHA NICHOLE LAYSTROM Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085008351

License Status

ACTIVE

Business

First Name

SAMANTHA

Middle

NICHOLE

Last Name

LAYSTROM

Business Name

SAMANTHA NICHOLE LAYSTROM

Original Issue Date

06/09/2021

Effective Date

01/20/2026

Expiration Date

03/01/2028

City

GRAYSLAKE

State

Zip

60030

County

LAKE

Ever Disciplined

LastModifiedDate

01/20/2026