HAYDEN BLAKE SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****35

License Status

NOT RENEWED

Business

Title

First Name

HAYDEN

Middle

BLAKE

Last Name

SMITH

Business Name

HAYDEN BLAKE SMITH MD

Original Issue Date

06/09/2009

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

O FALLON

State

Zip

62269

County

SAINT CLAIR

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021