RUSSEL D SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036082421

License Status

NOT RENEWED

Business

First Name

RUSSEL

Middle

Last Name

SMITH

Suffix

Business Name

RUSSEL D SMITH MD

Original Issue Date

05/11/1991

Effective Date

03/27/2020

Expiration Date

09/30/2020

City

CHICAGO

State

Zip

60610

Ever Disciplined

LastModifiedDate

01/14/2021