CASEY PATRICK SMITH DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125076423

License Status

CANCELLED

Business

Title

First Name

CASEY

Middle

PATRICK

Last Name

SMITH

Business Name

CASEY PATRICK SMITH DO

Original Issue Date

06/25/2020

Effective Date

06/25/2020

Expiration Date

06/24/2023

City

CHICAGO

State

Zip

60657

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

04/10/2020