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Keneisha
Keneisha
Smith
Registration for resident - hse ...
Boynton Beach, United States
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Reveal information
Florida Health Care Practitioner Data Portal
Full name
Keneisha Smith
Job Title
Registration for Resident/HSE Physician
Location
Boynton Beach, FL, USA
LIC ID
38834
Current License Expiration Date
30/06/2025
Original Date
25/06/2021
Professional Rank Code
TRN
Effective Date
25/06/2021
Board Action Indicator
N
License Status Description
CLEAR
License Active Status Description
ACTIVE
Country Description
PALM BEACH
Mailing Address Line 2
APT 305
Practice Location Address Line 1
5301 South Congress Avenue
Practice Location Address City
ATLANTIS
Practice Location Address State
FL
Practice Location Address Zipcode
33462
Prescribing Indicator
N
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