ELEANOR GWEN SMITH MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125054413

License Status

EXPIRED

Business

First Name

ELEANOR

Middle

GWEN

Last Name

SMITH

Suffix

Business Name

ELEANOR GWEN SMITH MD

Original Issue Date

06/30/2009

Effective Date

06/30/2009

Expiration Date

06/29/2011

City

EVANSTON

State

Zip

60201

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

07/19/2011