R THEODORE SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****53

License Status

NOT RENEWED

Business

First Name

R THEODORE

Last Name

SMITH

Suffix

Business Name

R THEODORE SMITH MD

Original Issue Date

06/03/1986

Effective Date

06/03/1986

Expiration Date

07/31/1987

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

09/26/2006