AMY MICHELLE SMITH Physician Assistant License verification

Business Entity

NOT RENEWED

License Type

Physician Assistant

Description

PHYSICIAN ASSISTANT CONTROLLED SUBSTANCE

License Number

38*****61

License Status

NOT RENEWED

Business

First Name

AMY

Middle

MICHELLE

Last Name

SMITH

Business Name

AMY MICHELLE SMITH

Original Issue Date

01/14/2010

Effective Date

01/14/2010

Expiration Date

03/01/2012

City

RED BUD

State

Zip

62278

County

RANDOLPH

Ever Disciplined

LastModifiedDate

09/24/2014