DOUGLAS EDWARD KELLEY OD - Optometrist License in Illinois | # 047935197

DOUGLAS EDWARD KELLEY OD

Business Entity

CANCELLED

License Type

Optometrist

Description

LICENSED OPTOMETRIST ANCILLARY OFFICE

License Number

047935197

License Status

CANCELLED

Business

N

First Name

DOUGLAS

Middle

EDWARD

Last Name

KELLEY

Suffix

OD

Business Name

DOUGLAS EDWARD KELLEY OD

Original Issue Date

03/28/2009

Effective Date

03/28/2009

Expiration Date

03/31/2010

State

IL

Ever Disciplined

N

LastModifiedDate

05/04/2010