TODD MICHAEL SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085001509

License Status

NOT RENEWED

Business

First Name

TODD

Middle

MICHAEL

Last Name

SMITH

Business Name

TODD MICHAEL SMITH

Original Issue Date

12/05/2000

Effective Date

12/05/2000

Expiration Date

03/01/2002

City

LAKELAND

State

Zip

33813

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/09/2006