RUSSEL D SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****12

License Status

NOT RENEWED

Business

First Name

RUSSEL

Middle

Last Name

SMITH

Suffix

Business Name

RUSSEL D SMITH MD

Original Issue Date

06/03/1991

Effective Date

05/22/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60657

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/05/2020