PATRICK MARK KELLEY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036048511

License Status

NOT RENEWED

Business

First Name

PATRICK MARK

Last Name

KELLEY

Suffix

Business Name

PATRICK MARK KELLEY MD

Original Issue Date

12/18/1973

Effective Date

12/18/1973

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

09/20/2006