SAMANTHA KLOSAK Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****39

License Status

ACTIVE

Business

First Name

SAMANTHA

Last Name

KLOSAK

Business Name

SAMANTHA KLOSAK

Original Issue Date

11/03/2021

Effective Date

01/22/2026

Expiration Date

03/01/2028

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/22/2026