MICHAEL C C KELLY DMD Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****59

License Status

NOT RENEWED

Business

Title

DMD

First Name

MICHAEL

Middle

C C

Last Name

KELLY

Business Name

MICHAEL C C KELLY DMD

Original Issue Date

03/08/2016

Effective Date

10/01/2018

Expiration Date

01/31/2022

City

YUMA

State

Zip

85365

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/09/2022