CHARELLE OCTAVIA SMITH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036153658

License Status

ACTIVE

Business

Title

First Name

CHARELLE

Middle

OCTAVIA

Last Name

SMITH

Business Name

CHARELLE OCTAVIA SMITH MD

Original Issue Date

07/09/2020

Effective Date

04/15/2023

Expiration Date

07/31/2026

City

DU QUOIN

State

Zip

62832

County

PERRY

Ever Disciplined

LastModifiedDate

04/15/2023