SAMANTHA MARIE COREY Physician Assistant License verification

Business Entity

INOPERATIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****73

License Status

INOPERATIVE

Business

First Name

SAMANTHA

Middle

MARIE

Last Name

COREY

Business Name

SAMANTHA MARIE COREY

Original Issue Date

11/08/2019

Effective Date

02/05/2022

Expiration Date

03/01/2024

City

BOURBONNAIS

State

Zip

60914

County

KANKAKEE

Ever Disciplined

LastModifiedDate

12/06/2023