ROGER R SMITH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085000789

License Status

ACTIVE

Business

First Name

ROGER

Middle

Last Name

SMITH

Business Name

ROGER R SMITH

Original Issue Date

03/07/1996

Effective Date

12/08/2023

Expiration Date

03/01/2026

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Ever Disciplined

LastModifiedDate

12/03/2025