JOSEPH BRADLEY SAMUELS Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****72

License Status

INOPERATIVE

Business

First Name

JOSEPH

Middle

BRADLEY

Last Name

SAMUELS

Business Name

JOSEPH BRADLEY SAMUELS

Original Issue Date

09/19/2018

Effective Date

01/08/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60612

Ever Disciplined

LastModifiedDate

12/06/2023