CARRIE RENEE SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

LICENSED PHYSICIAN ASSISTANT

License Number

085003827

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

RENEE

Last Name

SMITH

Business Name

CARRIE RENEE SMITH

Original Issue Date

08/19/2010

Effective Date

01/22/2014

Expiration Date

03/01/2016

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/28/2016