SANDRA SMITH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036094073

License Status

NOT RENEWED

Business

First Name

SANDRA

Last Name

SMITH

Business Name

SANDRA SMITH

Original Issue Date

08/21/1996

Effective Date

06/23/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60605

County

COOK

Ever Disciplined

LastModifiedDate

11/17/2014