LISA D KELLY MD Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036081165

License Status

NOT RENEWED

Business

First Name

LISA D

Last Name

KELLY

Suffix

Business Name

LISA D KELLY MD

Original Issue Date

07/27/1990

Effective Date

07/27/1990

Expiration Date

07/31/1993

City

SPRINGFIELD

State

Zip

62794

County

SANGAMON

Ever Disciplined

LastModifiedDate

07/10/2014