STEPHEN DALE SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036079523

License Status

NOT RENEWED

Business

First Name

STEPHEN

Middle

DALE

Last Name

SMITH

Suffix

Business Name

STEPHEN DALE SMITH MD

Original Issue Date

11/04/1989

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61637

County

PEORIA

Ever Disciplined

LastModifiedDate

11/14/2011