DONALD LYNN KELLEY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

RESTRICTED FACULTY LICENSE

License Number

136000083

License Status

NOT RENEWED

Business

First Name

DONALD

Middle

LYNN

Last Name

KELLEY

Suffix

DDS

Business Name

DONALD LYNN KELLEY DDS

Original Issue Date

07/01/2001

Effective Date

07/01/2001

Expiration Date

06/30/2003

City

ALTON

State

Zip

62002

County

MADISON

Ever Disciplined

LastModifiedDate

10/13/2005