AMY LEA SMITH DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125050153

License Status

EXPIRED

Business

First Name

AMY

Middle

LEA

Last Name

SMITH

Suffix

Business Name

AMY LEA SMITH DO

Original Issue Date

07/01/2005

Effective Date

07/01/2005

Expiration Date

06/30/2008

City

NORMAL

State

Zip

61761

County

MCLEAN

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

07/31/2008