IMELDA SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****04

License Status

NOT RENEWED

Business

First Name

IMELDA

Last Name

SMITH

Business Name

IMELDA SMITH

Original Issue Date

10/03/2013

Effective Date

01/09/2022

Expiration Date

03/01/2024

City

ELGIN

State

Zip

60123

County

KANE

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025