PRESTON GEORGE SMITH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125059885

License Status

CANCELLED

Business

Title

First Name

PRESTON

Middle

GEORGE

Last Name

SMITH

Business Name

PRESTON GEORGE SMITH MD

Original Issue Date

07/01/2012

Effective Date

07/01/2012

Expiration Date

06/30/2014

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

03/24/2014