KELLY ELIZABETH SMYTH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****50

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

ELIZABETH

Last Name

SMYTH

Business Name

KELLY ELIZABETH SMYTH

Original Issue Date

08/27/2018

Effective Date

01/12/2022

Expiration Date

03/01/2024

City

CHICAGO

State

Zip

60611

Delegated Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

02/05/2025