SAMUEL JOHN SPENCER Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****44

License Status

INOPERATIVE

Business

First Name

SAMUEL

Middle

JOHN

Last Name

SPENCER

Business Name

SAMUEL JOHN SPENCER

Original Issue Date

08/14/2012

Effective Date

08/14/2012

Expiration Date

03/01/2014

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

11/08/2013