BRIAN PATRICK KELLEY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****27

License Status

NOT RENEWED

Business

First Name

BRIAN

Middle

PATRICK

Last Name

KELLEY

Suffix

DDS

Business Name

BRIAN PATRICK KELLEY DDS

Original Issue Date

03/22/2000

Effective Date

03/22/2000

Expiration Date

09/30/2002

City

CHICAGO

State

Zip

60612

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/17/2005