JEREMY P SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036100962

License Status

NOT RENEWED

Business

First Name

JEREMY

Middle

Last Name

SMITH

Suffix

Business Name

JEREMY P SMITH MD

Original Issue Date

08/09/1999

Effective Date

07/08/2008

Expiration Date

07/31/2011

City

KEWANEE

State

Zip

61443

County

HENRY

Ever Disciplined

LastModifiedDate

11/14/2011