SAMUEL MAURICIO CORDOVA Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002213

License Status

ACTIVE

Business

First Name

SAMUEL

Middle

MAURICIO

Last Name

CORDOVA

Business Name

SAMUEL MAURICIO CORDOVA

Original Issue Date

02/19/2004

Effective Date

02/08/2024

Expiration Date

03/01/2026

City

SCHERERVILLE

State

Zip

46375

Ever Disciplined

LastModifiedDate

12/03/2025