PEGGIE ANN SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****03

License Status

NOT RENEWED

Business

First Name

PEGGIE

Middle

ANN

Last Name

SMITH

Business Name

PEGGIE ANN SMITH

Original Issue Date

03/08/2006

Effective Date

02/11/2010

Expiration Date

03/01/2012

City

CHICAGO

State

Zip

60612

County

COOK

Ever Disciplined

LastModifiedDate

04/16/2012