STEPHEN DALE SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****80

License Status

NOT RENEWED

Business

First Name

STEPHEN

Middle

DALE

Last Name

SMITH

Suffix

Business Name

STEPHEN DALE SMITH MD

Original Issue Date

06/13/2006

Effective Date

04/17/2008

Expiration Date

07/31/2011

City

PEORIA

State

Zip

61632

County

PEORIA

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/10/2011