SMITA NARESH SAMPAT MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****76

License Status

NOT RENEWED

Business

First Name

SMITA

Middle

NARESH

Last Name

SAMPAT

Suffix

Business Name

SMITA NARESH SAMPAT MD

Original Issue Date

10/07/2005

Effective Date

08/22/2008

Expiration Date

07/31/2011

City

CENTRALIA

State

Zip

62801

County

MARION

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011