WILLIAM ROBERT SMITH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057311

License Status

CANCELLED

Business

Title

First Name

WILLIAM

Middle

ROBERT

Last Name

SMITH

Business Name

WILLIAM ROBERT SMITH MD

Original Issue Date

02/18/2010

Effective Date

02/18/2010

Expiration Date

02/17/2013

City

CARBONDALE

State

Zip

62901

County

JACKSON

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

02/18/2010