JAYANTHI R SMUCKER MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****79

License Status

NOT RENEWED

Business

First Name

JAYANTHI

Middle

Last Name

SMUCKER

Suffix

Business Name

JAYANTHI R SMUCKER MD

Original Issue Date

08/12/1998

Effective Date

04/11/2017

Expiration Date

09/30/2020

City

GRANGER

State

Zip

46530

County

SANGAMON

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

01/14/2021