KELLY V BOMER - Medical Doctor License in Illinois | # 036102505

KELLY V BOMER

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036102505

License Status

NOT RENEWED

Business

N

First Name

KELLY

Middle

V

Last Name

BOMER

Business Name

KELLY V BOMER

Original Issue Date

05/18/2000

Effective Date

05/18/2000

Expiration Date

07/31/2002

State

IL

Ever Disciplined

N

LastModifiedDate

10/09/2006