GLEN B SMITH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125018121

License Status

EXPIRED

Business

First Name

GLEN B

Last Name

SMITH

Suffix

Business Name

GLEN B SMITH MD

Original Issue Date

06/13/1985

Effective Date

06/13/1985

Expiration Date

07/01/1988

City

SPRINGFIELD

State

Zip

62708

County

SANGAMON

Specialty/Qualifier

Addiction Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006