KRISTINA RENEE SAMSON Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****54

License Status

NOT RENEWED

Business

First Name

KRISTINA

Middle

RENEE

Last Name

SAMSON

Business Name

KRISTINA RENEE SAMSON

Original Issue Date

12/22/2014

Effective Date

02/22/2018

Expiration Date

03/01/2020

City

PITTSFIELD

State

Zip

62363

County

PIKE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020