MARK ALAN SMITH DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRIC PHYSICIAN

License Number

016004790

License Status

NOT RENEWED

Business

First Name

MARK

Middle

ALAN

Last Name

SMITH

Suffix

DPM

Business Name

MARK ALAN SMITH DPM

Original Issue Date

08/22/1996

Effective Date

11/04/2022

Expiration Date

02/28/2025

City

PEORIA

State

Zip

61614

County

PEORIA

Ever Disciplined

LastModifiedDate

01/21/2026