CRYSTAL MARIE SMITH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125045506

License Status

EXPIRED

Business

First Name

CRYSTAL

Middle

MARIE

Last Name

SMITH

Suffix

Business Name

CRYSTAL MARIE SMITH MD

Original Issue Date

04/01/2003

Effective Date

04/01/2003

Expiration Date

06/30/2006

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Psychiatry

Ever Disciplined

LastModifiedDate

09/22/2006