STEPHEN E SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000241

License Status

NOT RENEWED

Business

First Name

STEPHEN E

Last Name

SMITH

Business Name

STEPHEN E SMITH

Original Issue Date

01/28/1982

Effective Date

01/28/1982

Expiration Date

01/28/1985

City

BLOOMINGTON

State

Zip

61701

County

MCLEAN

Ever Disciplined

LastModifiedDate

09/26/2006