KEITH DOUGLAS SMART MD Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125066218

License Status

EXPIRED

Business

Title

First Name

KEITH

Middle

DOUGLAS

Last Name

SMART

Business Name

KEITH DOUGLAS SMART MD

Original Issue Date

06/24/2015

Effective Date

06/24/2015

Expiration Date

06/23/2018

City

CHICAGO

State

Zip

60637

County

COOK

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

10/25/2018