RICHARD WILLIAM SMITH DPM Podiatrist License verification

Business Entity

CANCELLED

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****70

License Status

CANCELLED

Business

First Name

RICHARD

Middle

WILLIAM

Last Name

SMITH

Suffix

DPM

Business Name

RICHARD WILLIAM SMITH DPM

Original Issue Date

01/01/1998

Effective Date

11/21/2006

Expiration Date

01/31/2009

City

ROCKFORD

State

Zip

61108

County

WINNEBAGO

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

12/12/2008