KELLY M FARROLL Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036093514

License Status

ACTIVE

Business

First Name

KELLY M

Last Name

FARROLL

Business Name

KELLY M FARROLL

Original Issue Date

07/11/1996

Effective Date

04/23/2023

Expiration Date

07/31/2026

City

SAUGET

State

Zip

62206

County

SAINT CLAIR

Ever Disciplined

LastModifiedDate

04/23/2023