Doctor Background Check Example
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PROVIDER INFORMATION
Name: MICHAEL JAMES SMITH
Address: 2390 W CONGRESS ST
LAFAYETTE LA 70506-4205 (LAFAYETTE COUNTY)
LAST UPDATE: 02-16-2000
4640 AMBASSADOR CAFFERY PKWY
LAFAYETTE LA 70508-6902 (LAFAYETTE COUNTY)
LAST UPDATE: 06-01-1997
Areas Of Practice: Obstetrics & Gynecology
LAST UPDATE: 11-13-2007
Family Practice
LAST UPDATE: 10-31-2006
Education: LOUISIANA STATE UNIV 1980 Doctor of Medicine
Residency: INTERNSHIP - LOUISIANA STATE UNIV MEDICAL CENTER OF NEW OR LA - 07-01-1980 to 06-30-1981
Government: ACTIVE DEA REGISTRATION AS OF 04-12-2004 [ EXPIRES 07-31-2004 ]
DRUG CLASSIFICATIONS
SCHEDULE 1 SUBSTANCES [ NO ]
SCHEDULE 2 NARCOTIC SUBSTANCES [ YES ]
SCHEDULE 2N NON-NARCOTIC SUBSTANCES [ YES ]
SCHEDULE 3 NARCOTIC SUBSTANCES [ YES ]
SCHEDULE 3N NON-NARCOTIC SUBSTANCES [ YES ]
SCHEDULE 4 SUBSTANCES [ YES ]
SCHEDULE 5 SUBSTANCES [ YES ]
Gender: MALE
Year Of Birth: 1951
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LICENSE INFORMATION
License #1
Issue Date: 06-12-1980
Type: MEDICAL DOCTOR
Expiration Date: 08-31-2004
License State: LA
License #2
Issue Date: 03-04-1994
Type: MEDICAL DOCTOR
Expiration Date: 08-31-2004
License State: TX
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LICENSE RELATED ACTION
License related actions and items, including disciplinary actions, sanctions, consent orders, consent agreements, dismissals, non-disciplinary communications, advisory letters and other licensing information.
Action #1
Action Date: 08-19-2003
State LA
Judgment: 0
Case Number: 02-I-014
Complaint: HABITUAL OR RECURRING ABUSE OF DRUGS, INCLUDING ALCOHOL; INABILITY TO PRACTICE MEDICINE WITH REASONABLE SKILL AND SAFETY TO PATIENTS, RS 37:1285A(5), (25). (ACTION) CONSENT ORDER - PHYSICIAN'S LICENSE PLACED ON PROBATION FOR FIVE YEARS CONDITIONED UPON APPEARANCE BEFORE THE PHYSICIANS' HEALTH COMMITTEE OF THE BOARD, PRACTICE RESTRICTED TO PARTICIPATION IN AND SUCCESSFUL COMPLETION OF A MEDICAL RESIDENCY OR OTHER TRAINING PROGRAM APPROVED BY THE BOARD, CONTINUING TREATMENT AND MONITORING, (CONT'D IN ACTION)
Reinstated Date:
Action: (CONT'D) CONTINUED PARTICIPATION IN THE PHYSICIANS' HEALTH FOUNDATION OF THE LOUISIANA'S PHYSICIANS' HEALTH PROGRAM, PERIODIC UNANNOUNCED DRUG SCREENS, SUBMISSION OF SPECIFIED WRITTEN REPORTS TO THE BOARD, LIFETIME ABSTINENCE FROM THE USE OF ALCOHOL, CONTROLLED AND ALL OTHER MOOD-ALTERING SUBSTANCES, PROHIBITION ON PRESCRIBING, DISPENSING OR ADMINISTERING CONTROLLED SUBSTANCES AND CERTAIN NON-CONTROLLED, COMPLETION OF SPECIFIED CONTINUING MEDICAL EDUCATION, IMPOSITION OF SUCH ADDITIONAL PROBATIONARY TERMS, CONDITIONS AND RESTRICTIONS AS MAY BE DEEMED APPROPRIATE BY THE BOARD, PAYMENT OF PROBATION MONITORING FEE, IMMEDIATE SUMMARY SUSPENSION OF LICENSURE FOR FAILURE TO COMPLY WITH THE TERMS AND CONDITIONS OF CONSENT ORDER, CERTIFICATION OF COMPLIANCE WITH PROBATIONARY TERMS, PERSONAL APPEARANCE BEFORE THE BOARD PRIOR TO THE CONCLUSION OF PROBATION.
Source: LOUISIANA STATE BOARD OF MEDICAL EXAMINERS
Action #2
Action Date: 12-10-2004
State TX
Judgment: 0
Case Number: "
Complaint: "
Reinstated Date:
Action: THE BOARD AND RESPONDENT ENTERED INTO AN AGREED ORDER SUSPENDING RESPONDENT'S LICENSE. ACTION BASED ON ALLEGATIONS THAT RESPONDENT SUFFERS FROM DRUG AND ALCOHOL ADDICTION AND RELAPSED, VIOLATING A PROBATION ORDER ISSUED BY THE LOUISIANA STATE BOARD OF MEDICAL EXAMINERS.
Source: TEXAS STATE BOARD OF
MEDICAL EXAMINERS
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