KELLY M MCLEOD DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****10

License Status

NOT RENEWED

Business

First Name

KELLY

Middle

Last Name

MCLEOD

Suffix

DDS

Business Name

KELLY M MCLEOD DDS

Original Issue Date

06/24/2004

Effective Date

12/11/2006

Expiration Date

09/30/2009

City

BERWYN

State

Zip

60402

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

11/04/2009