KEVIN L SMITH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025104

License Status

EXPIRED

Business

First Name

KEVIN

Middle

Last Name

SMITH

Business Name

KEVIN L SMITH

Original Issue Date

05/25/1990

Effective Date

05/25/1990

Expiration Date

06/30/1993

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006