CHASE PATRICK SMITH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125079472

License Status

CANCELLED

Business

Title

First Name

CHASE

Middle

PATRICK

Last Name

SMITH

Business Name

CHASE PATRICK SMITH MD

Original Issue Date

06/21/2022

Effective Date

06/21/2022

Expiration Date

06/20/2023

City

PEORIA

State

Zip

61605

County

PEORIA

Specialty/Qualifier

Transitional Year

Ever Disciplined

LastModifiedDate

04/13/2022