DAVID R SMITH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125060350

License Status

CANCELLED

Business

Title

First Name

DAVID

Middle

Last Name

SMITH

Business Name

DAVID R SMITH MD

Original Issue Date

06/22/2011

Effective Date

06/22/2011

Expiration Date

06/21/2014

City

MAYWOOD

State

Zip

60153

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

03/24/2014