PEGGIE ANN SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085002479

License Status

NOT RENEWED

Business

First Name

PEGGIE

Middle

ANN

Last Name

SMITH

Business Name

PEGGIE ANN SMITH

Original Issue Date

05/31/2005

Effective Date

02/11/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

04/11/2012