BRANT SMITH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125074485

License Status

CANCELLED

Business

Title

First Name

BRANT

Last Name

SMITH

Business Name

BRANT SMITH DO

Original Issue Date

07/01/2019

Effective Date

07/01/2019

Expiration Date

06/30/2022

City

WHEATON

State

Zip

60187

County

DUPAGE

Specialty/Qualifier

Physical Medicine and Rehabilitation

Ever Disciplined

LastModifiedDate

06/03/2021