SAMUEL MAURICIO CORDOVA Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****56

License Status

INOPERATIVE

Business

First Name

SAMUEL

Middle

MAURICIO

Last Name

CORDOVA

Business Name

SAMUEL MAURICIO CORDOVA

Original Issue Date

02/19/2004

Effective Date

02/08/2024

Expiration Date

03/01/2026

City

ORLAND PARK

State

Zip

60467

County

COOK

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025