TIMOTHY L SMITH MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102412

License Status

NOT RENEWED

Business

First Name

TIMOTHY

Middle

Last Name

SMITH

Suffix

Business Name

TIMOTHY L SMITH MD

Original Issue Date

05/03/2000

Effective Date

05/03/2000

Expiration Date

07/31/2002

City

BROOKFIELD

State

Zip

53045

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006