SAMANTHA L DAVIS Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****01

License Status

INOPERATIVE

Business

First Name

SAMANTHA

Middle

Last Name

DAVIS

Business Name

SAMANTHA L DAVIS

Original Issue Date

04/15/2011

Effective Date

03/03/2014

Expiration Date

03/01/2016

City

VERNON HILLS

State

Zip

60061

County

LAKE

Ever Disciplined

LastModifiedDate

01/21/2016