CHARLI W SMITH JR MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125064228

License Status

CANCELLED

Business

Title

First Name

CHARLI

Middle

Last Name

SMITH

Suffix

Business Name

CHARLI W SMITH JR MD

Original Issue Date

07/08/2013

Effective Date

07/08/2013

Expiration Date

07/07/2016

City

HARRISBURG

State

Zip

62946

County

SALINE

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

03/24/2014