ROBERT WYATT SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036119359

License Status

NOT RENEWED

Business

First Name

ROBERT

Middle

WYATT

Last Name

SMITH

Suffix

Business Name

ROBERT WYATT SMITH MD

Original Issue Date

09/06/2007

Effective Date

06/17/2008

Expiration Date

07/31/2011

City

ROCKFORD

State

Zip

61114

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/14/2011