MICHAEL DEREK SMITH - Orthotist, Prosthetist, and Pedorthist License in Illinois | # 212000167

MICHAEL DEREK SMITH

Business Entity

NOT RENEWED

License Type

Orthotist, Prosthetist, and Pedorthist

Description

LICENSED PEDORTHIST

License Number

212000167

License Status

NOT RENEWED

Business

N

First Name

MICHAEL

Middle

DEREK

Last Name

SMITH

Business Name

MICHAEL DEREK SMITH

Original Issue Date

03/19/2010

Effective Date

03/19/2010

Expiration Date

09/30/2011

State

IL

Ever Disciplined

N

LastModifiedDate

11/04/2011