LISA M KELLY DDS Dentist License verification

Business Entity

NOT RENEWED

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****70

License Status

NOT RENEWED

Business

First Name

LISA M

Last Name

KELLY

Suffix

DDS

Business Name

LISA M KELLY DDS

Original Issue Date

12/06/1993

Effective Date

12/06/1993

Expiration Date

09/30/1996

City

CHICAGO

State

Zip

60659

County

COOK

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

10/13/2005