CRISTINE MARIE SMITH Dentist License verification

Business Entity

CANCELLED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****12

License Status

CANCELLED

Business

First Name

CRISTINE

Middle

MARIE

Last Name

SMITH

Business Name

CRISTINE MARIE SMITH

Original Issue Date

10/25/2006

Effective Date

10/25/2006

Expiration Date

09/30/2009

City

BELLEVILLE

State

Zip

62226

County

SAINT CLAIR

Specialty/Qualifier

HOSPITAL/CLINIC

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

06/04/2009