JASON W SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****26

License Status

NOT RENEWED

Business

First Name

JASON

Middle

Last Name

SMITH

Suffix

Business Name

JASON W SMITH MD

Original Issue Date

01/24/2005

Effective Date

07/06/2011

Expiration Date

07/31/2014

City

CHICAGO

State

Zip

60654

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/17/2014