SAMUEL SUSKO Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****62

License Status

ACTIVE

Business

First Name

SAMUEL

Last Name

SUSKO

Business Name

SAMUEL SUSKO

Original Issue Date

06/16/2025

Effective Date

01/09/2026

Expiration Date

03/01/2028

City

SPRINGFIELD

State

Zip

62781

County

SANGAMON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/09/2026