SAMANTHA ALLISON MOOBERRY Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****84

License Status

ACTIVE

Business

First Name

SAMANTHA

Middle

ALLISON

Last Name

MOOBERRY

Business Name

SAMANTHA ALLISON MOOBERRY

Original Issue Date

06/23/2015

Effective Date

01/09/2026

Expiration Date

03/01/2028

City

PEKIN

State

Zip

61603

County

PEORIA

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/09/2026