KRISTEN DIANE SMITH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****89

License Status

ACTIVE

Business

Title

First Name

KRISTEN

Middle

DIANE

Last Name

SMITH

Business Name

KRISTEN DIANE SMITH MD

Original Issue Date

04/27/2012

Effective Date

04/14/2023

Expiration Date

07/31/2026

City

JOLIET

State

Zip

60435

County

WILL

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/11/2025