ANDREA JILL KELLY DMD Dentist License verification

Business Entity

EXPIRED

License Type

Dentist

Description

TEMPORARY DENTAL TRAINING LICENSE

License Number

018001551

License Status

EXPIRED

Business

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

City

MAYWOOD

State

Zip

60153

County

COOK

Specialty/Qualifier

General Practice Residency

Ever Disciplined

LastModifiedDate

07/27/2006