GAYLE DIANE SMITH DO Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

VISITING RESIDENT

License Number

188000235

License Status

EXPIRED

Business

First Name

GAYLE

Middle

DIANE

Last Name

SMITH

Suffix

Business Name

GAYLE DIANE SMITH DO

Original Issue Date

07/25/2005

Effective Date

07/25/2005

Expiration Date

01/24/2006

City

CHICAGO

State

Zip

60622

County

COOK

Specialty/Qualifier

Family Medicine

Ever Disciplined

LastModifiedDate

09/25/2006