SAMUEL A BAILEY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****58

License Status

ACTIVE

Business

First Name

SAMUEL

Middle

Last Name

BAILEY

Business Name

SAMUEL A BAILEY

Original Issue Date

01/28/2002

Effective Date

12/04/2025

Expiration Date

03/01/2028

City

ALTON

State

Zip

62002

County

MADISON

Delegated Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

12/04/2025