ROBERT RUSSELL SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000270

License Status

NOT RENEWED

Business

First Name

ROBERT RUSSELL

Last Name

SMITH

Business Name

ROBERT RUSSELL SMITH

Original Issue Date

04/12/1984

Effective Date

04/12/1984

Expiration Date

03/01/1994

City

PEORIA

State

Zip

61603

County

PEORIA

Ever Disciplined

LastModifiedDate

09/26/2006