SHANNON O'CONNOR SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****37

License Status

NOT RENEWED

Business

First Name

SHANNON

Middle

O'CONNOR

Last Name

SMITH

Suffix

Business Name

SHANNON O'CONNOR SMITH MD

Original Issue Date

06/01/2000

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

KEWANEE

State

Zip

61443

County

HENRY

Controlled Substance Schedule

II III IV

Ever Disciplined

LastModifiedDate

11/10/2011