PHILIP DOUGLAS KELLEY MD Medical Doctor License verification

Business Entity

INACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036101202

License Status

INACTIVE

Business

First Name

PHILIP

Middle

DOUGLAS

Last Name

KELLEY

Suffix

Business Name

PHILIP DOUGLAS KELLEY MD

Original Issue Date

09/02/1999

Effective Date

09/02/1999

Expiration Date

07/31/2002

City

FORT MEYERS

State

Zip

33912

County

FLORIDA

Ever Disciplined

LastModifiedDate

10/09/2006