TRAVIS RICHARD SMITH DO Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153758

License Status

ACTIVE

Business

Title

First Name

TRAVIS

Middle

RICHARD

Last Name

SMITH

Business Name

TRAVIS RICHARD SMITH DO

Original Issue Date

07/17/2020

Effective Date

07/25/2023

Expiration Date

07/31/2026

City

LEWISTON

State

Zip

83501

Ever Disciplined

LastModifiedDate

07/25/2023