RICHARD WILLIAM SMITH DPM Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016002720

License Status

INACTIVE

Business

First Name

RICHARD

Middle

WILLIAM

Last Name

SMITH

Suffix

DPM

Business Name

RICHARD WILLIAM SMITH DPM

Original Issue Date

06/29/1972

Effective Date

02/01/2007

Expiration Date

01/31/2009

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Ever Disciplined

LastModifiedDate

11/14/2008