KENNETH R SMITH JR MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036045909

License Status

INACTIVE

Business

Title

First Name

KENNETH

Middle

Last Name

SMITH

Suffix

Business Name

KENNETH R SMITH JR MD

Original Issue Date

07/31/1972

Effective Date

10/06/2017

Expiration Date

09/30/2020

City

SAINT LOUIS

State

Zip

63110

Ever Disciplined

LastModifiedDate

04/05/2020