MARNA RACENE SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****73

License Status

NOT RENEWED

Business

Title

First Name

MARNA

Middle

RACENE

Last Name

SMITH

Business Name

MARNA RACENE SMITH MD

Original Issue Date

06/19/2008

Effective Date

06/19/2008

Expiration Date

07/31/2011

City

BLOOMINGTON

State

Zip

61704

County

MCLEAN

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011