DEREK W SMITH Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036112062

License Status

NOT RENEWED

Business

First Name

DEREK

Middle

Last Name

SMITH

Business Name

DEREK W SMITH

Original Issue Date

08/10/2004

Effective Date

04/21/2014

Expiration Date

07/31/2017

City

SARATOGA SPRINGS

State

Zip

12866

County

NEW YORK

Ever Disciplined

LastModifiedDate

11/01/2017