KEENEN DWAYNE SMITH MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036168278

License Status

ACTIVE

Business

Title

First Name

KEENEN

Middle

DWAYNE

Last Name

SMITH

Business Name

KEENEN DWAYNE SMITH MD

Original Issue Date

01/16/2024

Effective Date

01/16/2024

Expiration Date

07/31/2026

City

PHILADELPHIA

State

Zip

19104

Ever Disciplined

LastModifiedDate

12/14/2023