BRIAN A SMITH Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125041365

License Status

EXPIRED

Business

First Name

BRIAN

Middle

Last Name

SMITH

Business Name

BRIAN A SMITH

Original Issue Date

06/19/2000

Effective Date

06/19/2000

Expiration Date

06/18/2003

City

RIVER FOREST

State

Zip

60305

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/22/2006