SAMANTHA ELAN HOLLIS Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

NOT RENEWED

Business

First Name

SAMANTHA

Middle

ELAN

Last Name

HOLLIS

Business Name

SAMANTHA ELAN HOLLIS

Original Issue Date

01/02/2007

Effective Date

01/02/2007

Expiration Date

03/01/2008

City

HARVEY

State

Zip

60426

County

COOK

Ever Disciplined

LastModifiedDate

03/04/2008