ROGER R SMITH Physician Assistant License verification

Business Entity

ACTIVE

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****21

License Status

ACTIVE

Business

First Name

ROGER

Middle

Last Name

SMITH

Business Name

ROGER R SMITH

Original Issue Date

10/07/2002

Effective Date

12/08/2023

Expiration Date

03/01/2026

City

HERRIN

State

Zip

62948

County

WILLIAMSON

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/03/2025