SUSAN ELAINE KELLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036060040

License Status

NOT RENEWED

Business

First Name

SUSAN ELAINE

Last Name

KELLY

Suffix

Business Name

SUSAN ELAINE KELLY MD

Original Issue Date

02/19/1980

Effective Date

02/19/1980

Expiration Date

07/01/1982

City

CHICAGO

State

Zip

60614

County

COOK

Ever Disciplined

LastModifiedDate

09/20/2006