CARRIE RENEE SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****22

License Status

NOT RENEWED

Business

First Name

CARRIE

Middle

RENEE

Last Name

SMITH

Business Name

CARRIE RENEE SMITH

Original Issue Date

09/09/2010

Effective Date

01/22/2014

Expiration Date

03/01/2016

City

DOWNERS GROVE

State

Zip

60515

County

DUPAGE

Ever Disciplined

LastModifiedDate

04/28/2016