SAMANTHA MOLLENHAUER Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

INOPERATIVE

Business

First Name

SAMANTHA

Last Name

MOLLENHAUER

Business Name

SAMANTHA MOLLENHAUER

Original Issue Date

10/08/2023

Effective Date

12/16/2023

Expiration Date

03/01/2026

City

JOLIET

State

Zip

60435

County

WILL

Ever Disciplined

LastModifiedDate

12/03/2025