Samantha K Black
ExpiredIllinois license 38*****20
License
- Licensed by
- Illinois Department of Financial and Professional Regulation
- License number
- 38*****20
- Status
- Expired (Not Renewed)
- First issued
- May 17, 2016
- Expired
- March 1, 2022
- License holder
- Samantha K Black
- Entity type
- Individual
Classifications
- Physician Assistant Controlled Substance Physicians & Surgeons
More from the license record
- Delegated controlled substance schedules
- II III IV V
- Current term began
- 04/22/2020
Other Illinois licenses under this name
-
IL
ExpiredPark Ridge, ILExpired Mar 1, 2022
Contact
Chicago, IL 60637
Cook County