BRIAN PATRICK KELLEY DDS Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001164

License Status

EXPIRED

Business

First Name

BRIAN

Middle

PATRICK

Last Name

KELLEY

Suffix

DDS

Business Name

BRIAN PATRICK KELLEY DDS

Original Issue Date

06/15/1999

Effective Date

06/15/1999

Expiration Date

06/30/2003

City

CHICAGO

State

Zip

60612

County

COOK

Specialty/Qualifier

Oral and Maxillofacial Surgery

Ever Disciplined

LastModifiedDate

10/12/2005