BRYAN ANTHONY SMITH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125058719

License Status

CANCELLED

Business

Title

First Name

BRYAN

Middle

ANTHONY

Last Name

SMITH

Business Name

BRYAN ANTHONY SMITH MD

Original Issue Date

06/24/2010

Effective Date

06/24/2010

Expiration Date

06/23/2013

City

CHICAGO

State

Zip

60637

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

05/13/2010