HARRIS LAKE SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036041049

License Status

NOT RENEWED

Business

First Name

HARRIS LAKE

Last Name

SMITH

Suffix

Business Name

HARRIS LAKE SMITH MD

Original Issue Date

05/25/1967

Effective Date

05/25/1967

City

JACKSON

State

Zip

60611

County

TENNESSEE

Ever Disciplined

LastModifiedDate

09/20/2006