ELBERT BOHANNON SMITH MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****93

License Status

CANCELLED

Business

First Name

ELBERT BOHANNON

Last Name

SMITH

Suffix

Business Name

ELBERT BOHANNON SMITH MD

Original Issue Date

01/01/1997

Effective Date

05/08/2014

Expiration Date

07/31/2017

City

CHICAGO

State

Zip

60617

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/05/2014