AUDRA MARIE SMITH DPM Podiatrist License verification

Business Entity

NOT RENEWED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****45

License Status

NOT RENEWED

Business

Title

DPM

First Name

AUDRA

Middle

MARIE

Last Name

SMITH

Business Name

AUDRA MARIE SMITH DPM

Original Issue Date

08/12/2009

Effective Date

11/03/2010

Expiration Date

01/31/2013

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

03/20/2013