Information as of 08/12/2020

Last Updated by Licensee on 12/10/2019

Tracey Smith PA-C
License#: 
Issue Date: 
102582
01/23/1999
License Status: 
Renewal Date:
Active  
02/13/2021  
 Public Action: Yes
 See: Actions-Adverse & Administrative Tab
Licensee General Information
Active License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 102582PA-C01/23/1999 
Inactive License
Reason CodeLicense NumberSubcategoryIssue DateExpire Date
 0090-01776PA-C01/23/199908/30/2005
Revoked102582PA-C01/23/199903/12/2007
Surrendered102582PA-C01/23/199908/30/2005
Active Supervisor
SupervisorTypeStatusApproval Date
Thomas-Montilus, Sandhya Anne MDActive11/01/2019
North Carolina Hospital Admitting Privileges
Out of State Active/Inactive Licenses
South Carolina
Out of Country Active/Inactive Licenses
None Reported