KEVIN DENNIS SMITH DPM Podiatrist License verification

Business Entity

INACTIVE

License Type

Podiatrist

Description

LICENSED PODIATRY CONTROLLED SUBSTANCE

License Number

31*****96

License Status

INACTIVE

Business

First Name

KEVIN

Middle

DENNIS

Last Name

SMITH

Suffix

DPM

Business Name

KEVIN DENNIS SMITH DPM

Original Issue Date

12/28/1998

Effective Date

11/08/2020

Expiration Date

01/31/2023

City

MOLINE

State

Zip

61265

County

ROCK ISLAND

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/02/2022