ANDREA JILL KELLY DMD - Dentist License in Illinois | # 018001551

ANDREA JILL KELLY DMD

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001551

License Status

EXPIRED

Business

N

First Name

ANDREA

Middle

JILL

Last Name

KELLY

Suffix

DMD

Business Name

ANDREA JILL KELLY DMD

Original Issue Date

06/15/2005

Effective Date

06/15/2005

Expiration Date

06/30/2006

State

IL

Specialty/Qualifier

General Practice Residency

Ever Disciplined

N

LastModifiedDate

07/27/2006