JERRY S 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

JERRY

Middle

Last Name

SMITH

Business Name

JERRY S SMITH

Original Issue Date

07/16/2015

Effective Date

02/27/2018

Expiration Date

03/01/2020

City

METROPOLIS

State

Zip

62960

County

MASSAC

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/24/2020